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Eight insurers have announced they will stop offering individual ACA marketplace plans, either nationally or in specific states, after the 2026 plan year, marking a significant wave of insurers exiting ACA markets 2027 as the exchange landscape continues to shift.
What’s Driving This Round of Insurers Exiting ACA Markets 2027
The withdrawals come amid declining enrollment nationwide, rising premiums and the expiration of enhanced premium tax credits at the end of 2025. This combination of enrollment decline and subsidy expiration has created compounding pressure on insurers’ individual market risk pools, prompting several companies to reassess their marketplace participation heading into the 2027 plan year.
The Scale of Cigna’s Departure
Cigna is exiting the exchange in Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia, affecting about 369,000 members, making it the largest single withdrawal among this group of exiting ACA markets 2027.
Regional Insurers Exiting ACA Markets 2027 Across Multiple States
Medica will no longer offer individual marketplace plans in Iowa, Kansas and Oklahoma past 2026. Centene will discontinue ACA coverage in New Hampshire at the end of 2026. PacificSource will stop offering ACA plans in Oregon, Idaho and Montana.
Baylor Scott & White and CareSource’s Texas and Indiana Exits
Baylor Scott & White Health Plan’s discontinuation of exchange coverage will affect roughly 100,000 Texas enrollees, or about 2.6% of the state’s marketplace. CareSource will exit Indiana’s ACA marketplace, leaving roughly 60,000 members to find new coverage, adding to the insurer’s previous exits from Kentucky, Michigan and North Carolina for the 2026 plan year.
Providence and Mending Round Out This List of Insurers Exiting ACA Markets 2027
Providence Health Plan is winding down most of its business, including its Oregon ACA plans, as part of a broader operational wind-down rather than an ACA-specific decision. Mending, formerly Taro Health, is exiting the health insurance business entirely in 2027, leaving the Maine and Oklahoma marketplaces, as the company shifts toward a direct primary care platform for self-funded employers and third-party administrators.
Why Mending’s Exit Differs From the Others
Unlike the other seven on this list, which are narrowing their ACA participation while continuing to operate as traditional health insurers, Mending’s departure reflects a complete business model pivot away from insurance carriage entirely, distinguishing its exit from the broader pattern of marketplace consolidation driving the other seven departures.
How This Pattern of Insurers Exiting ACA Markets 2027 Reflects Broader Market Pressure
Taken together, these eight exits span both large national insurers like Cigna and Centene and more regional players like PacificSource and CareSource, suggesting the pressures driving marketplace withdrawal, declining enrollment, rising premiums, and subsidy expiration, are affecting insurers of varying size and geographic scope rather than being isolated to any single business model or market segment.
What These Exits Mean for Affected Enrollees
With CareSource’s Indiana exit alone displacing roughly 60,000 members and Baylor Scott & White’s Texas departure affecting about 100,000 enrollees, the cumulative number of marketplace members needing to find new coverage across all eight exits likely reaches well into the hundreds of thousands nationally.
What This Insurers Exiting ACA Markets 2027 Trend Means Going Forward
With enrollment already declining nationally and insurers citing both rising medical costs and the subsidy expiration as drivers, this wave of eight departures suggests the ACA individual market is undergoing a meaningful contraction in carrier participation heading into 2027. Given that this list has already grown since its original June publication, with two additional added by the July update, this trend may continue evolving as more companies finalize their 2027 marketplace participation decisions.
What to Watch Going Forward
As affected enrollees in Texas, Indiana, Oregon, New Hampshire, and other states work to find replacement coverage ahead of the 2027 plan year, industry observers will likely watch whether additional insurers announce further withdrawals as the marketplace risk pool continues shifting toward a smaller, potentially higher-acuity population. Given the scale of members affected by just these eight exits, state insurance regulators and marketplace administrators may face mounting pressure to ensure adequate carrier competition remains in the specific counties and states most affected by this pattern of insurers exiting ACA markets 2027.
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