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- calendar_today October 29, 2026
Rising Uncertainty in ACA Marketplaces
Millions of Americans relying on health insurance through Affordable Care Act (ACA) marketplaces may face a new crisis in 2027. Eleven insurers have announced plans to leave some state ACA marketplaces, with major companies such as Cigna planning to exit every state where they currently offer ACA plans. This trend raises concerns about coverage continuity, market stability, and rising healthcare costs for consumers.
Open Enrollment Begins Amid Fewer Choices
For most states, ACA open enrollment begins on Sunday, giving individuals about two months to review and select their health insurance plans. However, the pool of options is expected to be smaller next year. According to an analysis by the nonpartisan health policy group KFF, more insurance companies are leaving ACA marketplaces than entering them in 2027. This shift could mean less competition and fewer insurance plans for enrollees to choose from.
Double-Digit Premium Increases Projected
Alongside insurer exits, remaining ACA plan providers are proposing a median premium increase of about 15% for 2027—the second consecutive year of double-digit increases, KFF’s survey of public filings across all 50 states and Washington, D.C. found. These ongoing premium increases add strain for Americans already struggling with health insurance costs.
Personal Stories: Strain from Costs and Instability
Some individuals are already feeling the impacts of these shifts. Courtney Mroch, a 56-year-old cancer survivor with diabetes and asthma from Nashville, Tennessee, pays $1,250 a month for an ACA silver plan with Cigna, up from $850 in 2025. With her insurer pulling out of the Tennessee marketplace, she remains unsure who will cover her in 2027 or what it will cost. Other families, like Denise O’Connor’s in Colorado, have also seen monthly premiums more than double, forcing some to tap into retirement savings or consider going uninsured until eligible for Medicare.
Mark Lathrop of Idaho, who owns a business in Washington, and his wife are seeking new coverage after their insurer, PacificSource, announced its withdrawal from the ACA market. A comparable plan for 2027 could cost about $17,600, compared to $16,000 the previous year. Both Cigna and PacificSource cited a need to ensure long-term business viability amid increasing healthcare industry pressures.
Why Are Insurers Leaving ACA Marketplaces?
One factor behind the insurer exits is the expiration of enhanced tax credits at the end of 2025, which caused ACA enrollment to drop by about 3 million. Healthier individuals have moved to cheaper but less comprehensive plans or dropped coverage altogether, leaving insurers with a higher proportion of individuals needing more medical care. Rising healthcare costs have made ACA marketplaces less profitable for insurance companies. As Jennifer Chumbley Hogue, a Texas-based insurance broker, noted, consumers face constant upheaval—whether from plan withdrawals, subsidy changes, or shifting provider networks.
Impact on Consumers and Public Support
The reduction in participating insurers may lead to disruptions in care, particularly for those with chronic illnesses who may lose access to preferred doctors. Miranda Yaver, assistant professor of health policy at the University of Pittsburgh, warned that fewer plan options and higher costs could discourage people from remaining enrolled, potentially weakening the ACA law’s effectiveness.
Public favorability toward the ACA has already declined, with a recent KFF poll indicating a drop to 58% from 64%. Yaver observes that even without repeal efforts, growing instability is making it harder for patients to maintain coverage.
Advice for ACA Enrollees
Experts recommend that ACA enrollees carefully review their options during the open enrollment period, rather than relying solely on mailed notices, as available premiums and subsidies may change from initial projections.
Source: nbcnews.com.
