KFF's Tracker Counts 11 Insurers Leaving the ACA Marketplaces for 2027 and Seven Entering, as Cigna Exits All 11 States Where It Sells Individual Plans After Enrollment Fell by More Than a Million

More health insurers have announced that they will leave the Affordable Care Act (ACA) Marketplaces for 2027 than have announced they will enter them. That is the picture in the insurer participation tracker maintained by KFF, the health policy research organisation. KFF first published the brief on June 11, 2026 and updated it on October 28, 2026. KFF warns that the information may change as insurers make further announcements, and this article reports the tracker as it stood at the October update. The portion of the page reviewed for this article does not name most of the carriers, so it describes the totals and the one insurer the text names, Cigna.

The totals

As of October 28, KFF counts 11 carriers that have announced they will leave ACA Marketplaces for plan year 2027, either completely or in some of the states where they operate. Seven carriers have announced they will enter new state Marketplaces. The exits therefore outnumber the entries by four, calculated here, although the tracker counts carriers, not enrollees, so the numbers do not show how many people are affected on either side.

KFF groups insurers by parent company and compiled the data from several sources: Mark Farrah Associates enrollment data, the Centers for Medicare and Medicaid Services (CMS) Qualified Health Plan landscape files, CMS medical loss ratio public use files, HIX Compare data from the Robert Wood Johnson Foundation, Healthinsurance.org and press materials.

Cigna

The one carrier the reviewed text describes in detail is Cigna. It is leaving the individual market in 2027 to focus on other segments, citing limited potential to grow its ACA business. Cigna reported more than 350,000 on-exchange enrollees in the first quarter of 2026 and will exit all 11 states in which it participates, both on and off the exchange. This article does not report an enrollment figure beyond the 350,000, because the text reviewed gives no other number. Members of a departing insurer generally have to pick a new plan during open enrollment, but the tracker does not discuss the mechanics, and consumers should rely on notices from their insurer and their state Marketplace.

Why insurers are pulling back

KFF links the changes to the expiration of the enhanced premium tax credits at the end of 2025. Enrollment fell by more than a million between the 2025 and 2026 open enrollment periods, and KFF expects further declines during 2026. KFF adds that enrollment declines could shrink the risk pool if healthier enrollees drop coverage, which would leave a sicker pool on average.

The same concern appears in KFF's separate analysis of proposed 2027 premiums, reported in July by MedCity News and the Associated Press. That analysis found a median proposed increase of 14% across 77 insurers in 16 states and Washington, D.C., and said insurers expected the market to keep deteriorating in 2027. Those proposals were preliminary, and this article has not verified the final approved rates.

What fewer insurers could mean

KFF notes that some states have more than one insurer exiting. In those states, consumers may have fewer choices and competition may decline. The tracker does not say in which states, and the text reviewed does not list them. It would be wrong to assume that every state faces a loss of choice, because seven carriers are entering new state Marketplaces, and some of those entries could offset exits in particular states. The tracker as reviewed does not say.

What the tracker does not say

The reviewed text does not name the other 10 exiting carriers, does not name the entrants, does not give the total number of affected enrollees and does not list the affected states. KFF's page evidently contains a table with that detail, which was not part of the text available. This article therefore does not make claims about any carrier other than Cigna. It also does not say how many counties will be left with a single insurer, because the tracker as reviewed gives no such figure.

The tracker is explicitly a running record. KFF says insurer information may change, which means that both the 11 exits and the seven entries could be revised by the time open enrollment starts. Readers should check the current version of the tracker and their state Marketplace for the carriers available where they live.

How the tracker was built

Because the tracker groups insurers by parent company, a single parent that sells under several brand names counts once. That affects comparisons: a count of carriers is not a count of plans, and one parent exiting a state can remove several plans at once. The tracker is also built from enrollment data, regulatory filings and press materials.

What consumers can do

The tracker is a research brief, not consumer guidance, but its findings point to some practical steps. People covered by an insurer that is leaving should watch for a notice from the insurer and their state Marketplace and compare the plans available in their area, including premiums, deductibles and provider networks. Anyone with a subsidy should check how it applies to a new plan. Those who stay with an insurer that is not leaving should still review their renewal notice, because premiums and benefits can change from year to year.