Cigna Exits 11 States as ACA Premiums Rise 15%

ACA marketplaces in most states open for enrollment on Sunday, offering buyers a two-month window to compare plans for next year. The 2027 cycle arrives with insurers proposing an average premium increase of 15% across all 50 states and Washington, D.C., according to an analysis by the Kaiser Family Foundation. This marks the second consecutive year of double-digit price hikes.

Cigna is among 11 insurers announcing departures from ACA marketplaces in 2027. The company plans to exit all 11 states where it currently offers coverage, affecting more than 350,000 enrollees. Six other insurers have announced plans to enter new markets, but KFF director Cynthia Cox noted that more companies are leaving than arriving. "The main takeaway is that more insurance companies are leaving the marketplace than coming in," Cox said.

The departures follow the expiration of enhanced tax credits at the end of 2025, which reduced ACA enrollment by roughly 3 million people. Jennifer Chumbley Hogue, a Texas insurance broker, explained that healthier individuals moved to cheaper plans or dropped coverage, leaving a pool with higher medical costs. This shift reduces marketplace profitability as healthcare costs rise.

Consumers in affected states face immediate financial pressure. Courtney Mroch, a 56-year-old Nashville resident with diabetes and asthma, pays $1,250 monthly for a silver plan, up from $850 in 2025. Her husband is enrolled in a separate, non-ACA plan to reduce household costs. "Who knows who will cover me in 2027 or how much more it’ll cost," Mroch said.

In Colorado, Denise O’Connor and her husband saw their monthly premiums more than double this year, rising from just over $900 to approximately $2,300. The couple, also covered by Cigna, has dipped into retirement savings to pay. O’Connor’s husband is considering going uninsured for six weeks until he qualifies for Medicare. "It’s a worry," she said. "He’s healthy, but anything can happen at any time."

Mark Lathrop, an Idaho winery owner, is seeking new coverage after PacificSource decided to exit the market. He does not qualify for standard subsidies and faces a comparable 2027 plan costing about $17,600, up from $16,000 last year. He requires an annual MRI for a spinal cord injury that costs $2,400. A PacificSource spokesperson stated the exit was not "made lightly" and was necessary to serve members long term amid growing industry pressures.

University of Pittsburgh assistant professor Miranda Yaver warned that fewer options could disrupt care for those with chronic illnesses. She noted that if available plans do not accept a patient's doctor, coverage can become disruptive. "This is going to create a lot of discontinuities in care and coverage for people," Yaver said.