Nine insurers have told regulators they are leaving the Affordable Care Act marketplace for 2027, according to a tracker maintained by the health policy nonprofit KFF, as the industry reassesses its exposure after enrollment fell by more than a million people this year. The pullback follows the expiration of enhanced premium tax credits at the end of 2025, which pushed monthly costs higher for millions of marketplace shoppers and thinned out the pool of healthy enrollees insurers rely on to keep prices down. For people in their late fifties and early sixties who buy coverage on the marketplace before Medicare eligibility begins, the exits mean fewer choices in some counties right as premiums are already climbing.
The Nine Carriers Leaving the ACA Marketplace
As of Sept. 15, 2026, nine carriers have announced they will exit the ACA marketplaces for plan year 2027 in some or all of the states where they currently sell plans, while six carriers have announced plans to enter new state marketplaces, according to KFF’s insurer participation tracker. Cigna is among the largest departures, exiting the individual market entirely in the 11 states where it currently participates both on- and off-exchange; the company reported more than 350,000 on-exchange enrollees as of the first quarter of 2026, according to its own earnings supplement. KFF attributed Cigna’s exit to shrinking growth potential in a small-business line the company has decided to deprioritize.
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Why the Enhanced Subsidies’ Expiration Is Reshaping the Market
The exits trace back to a single policy change: enhanced premium tax credits that had lowered marketplace premiums for millions of enrollees expired at the end of 2025 and were not renewed. Sign-ups fell by more than a million people between the 2025 and 2026 open enrollment periods as a result, and KFF expects further declines in marketplace membership as 2026 progresses. A smaller, pricier risk pool changes the math for insurers, since healthier enrollees tend to be the first to drop coverage once subsidies shrink, leaving carriers with a costlier remaining population to insure at the same premium.
Fewer Insurers, Higher Premiums in Some Counties
In a number of states, more than one insurer has announced an exit for the same market, which leaves the carriers that remain with less competition and consumers with fewer plan choices heading into open enrollment. That dynamic tends to put upward pressure on premiums independent of the subsidy expiration, since a marketplace with only one or two insurers left has less pricing discipline than one with five or six competing for the same customers. Shoppers renewing coverage this fall should expect to see both effects at once: a smaller subsidy and, in some counties, a thinner field of plans to choose from.
Marketplace shoppers have their own separate calendar to track, distinct from the Medicare enrollment dates that dominate the fall. Open enrollment for 2027 ACA coverage runs Nov. 1, 2026, through Jan. 15, 2027, in the states that use HealthCare.gov, though several state-run exchanges set their own, sometimes longer, windows. Anyone whose current insurer is exiting will be automatically shifted to a similar plan from a remaining carrier if they take no action, but an automatic reassignment does not check whether that replacement plan still covers the same doctors, hospitals or prescriptions, which is why insurance regulators and consumer advocates continue to recommend actively shopping rather than accepting the default.
The stakes are highest for people between roughly age 60 and Medicare eligibility at 65, a group that tends to use more medical care than younger marketplace shoppers and has fewer years left to absorb a premium increase before qualifying for Medicare. For that group, an insurer exit combined with a smaller subsidy can mean choosing between a materially higher monthly premium and a plan with a narrower network than the one they are used to, right at an age when continuity of care with a specialist often matters most.
The Cost Questions a Marketplace Exit Doesn’t Answer
The article above explains who is leaving and why, not what actually happens to a household’s health costs once ACA subsidies shift again or Medicare eligibility arrives at 65. That transition, not an insurer’s exit announcement, is where the real cost questions sit for anyone within a few years of Medicare.
The Medicare Cost & Coverage Protection Kit is a 10-page kit that walks through the new Part D out-of-pocket cap and the prior-authorization appeal steps, alongside a medication and cost tracker for watching premiums move.
Look up the Part D out-of-pocket cap in The Medicare Cost & Coverage Protection Kit.
This article was reported and written with the assistance of AI tools and reviewed by The Financial Wire editorial team.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
