Is Your ACA Plan Ending in 2027? Cigna Quits All 11 States (369,000 Enrollees) and a Dozen Insurers Exit — Pick a New Plan by Dec. 15 or Get Auto-Assigned (Oct. 18)

If your ACA insurer is leaving after Dec. 31, 2026, the notice in your mailbox matters more than the auto-renewal email: on HealthCare.gov you’ll likely be matched to a different company’s plan unless you choose your own by Dec. 15. Photo: Nicola Barts / Pexels (7926705), Pexels License.

Last updated Oct. 18, 2026. Insurer exits and enrollee counts come from healthinsurance.org’s exit tracker (updated Oct. 8) and the KFF insurer-participation tracker (updated Oct. 7). Enrollment rules come from HealthCare.gov and CMS. Insurer footprints can still change before Nov. 1, so check your own notice and your state’s Marketplace. This is education, not personalized insurance or tax advice.

If you buy your own health insurance through HealthCare.gov or a state exchange, the most important letter you open this fall may not be about price. It may say your plan simply won’t exist on Jan. 1.

For 2027 coverage, the Affordable Care Act Marketplace is going through its biggest round of insurer exits in years. Cigna is leaving the individual market in all 11 states where it sells Marketplace plans — Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia — affecting about 369,000 enrollees, according to healthinsurance.org. Baylor Scott & White Health Plan (about 100,000 Texans), CareSource (Indiana, Ohio, West Virginia), PacificSource (Idaho, Montana, Oregon), Providence (Oregon), Medica (Iowa, Kansas, Oklahoma), Celtic/Ambetter (Delaware, New Hampshire), UnitedHealthcare (Georgia), Molina (Illinois, Mississippi and more) and several smaller carriers are pulling out too. Healthinsurance.org counts exits touching 24 states; KFF’s Oct. 7 update counts 11 carriers exiting some or all of their states and only six entering new ones.

Your current coverage is safe through Dec. 31, 2026, as long as you keep paying premiums. The risk is what happens next. On HealthCare.gov, the Marketplace will usually drop you into a replacement plan from another company if you do nothing — a plan picked by an algorithm, not by you. In at least one state-run exchange (Colorado), affected Cigna members are not automatically moved, and anyone who bought off-exchange gets no automatic replacement anywhere. This guide walks through who is leaving, the exact deadlines, the 2027 numbers that matter (a $12,000 out-of-pocket cap, HSA-eligible Bronze plans and bigger subsidies tied to higher benchmark premiums), and a step-by-step plan to pick your own replacement before Dec. 15.

We covered the subsidy side of 2027 enrollment on Oct. 9 in ACA Open Enrollment for 2027 Starts November 1: What the Expired Subsidies Mean for Your Premium. Today’s post is about the narrower, more urgent problem: your insurer is gone, and you need a new plan anyway.

The 30-second version

• Who: Cigna exits all 11 of its Marketplace states (~369,000 people). At least a dozen insurers in total are leaving some or all states after Dec. 31, 2026. Disclosed enrollee counts alone add up to roughly 690,000 people.
• Your 2026 plan keeps working through Dec. 31. Keep paying premiums; nothing ends early in the exits announced so far.
• Open Enrollment runs Nov. 1, 2026 – Jan. 15, 2027 on HealthCare.gov. Pick a plan by Dec. 15 for coverage on Jan. 1.
• Do nothing on HealthCare.gov and you will likely be auto-assigned to a comparable plan from a different insurer. It may not include your doctors or drugs.
• State exchanges vary. Colorado has said Cigna enrollees won’t be auto-moved. Off-exchange enrollees get no automatic plan anywhere.
• Backup window: losing your plan triggers a Special Enrollment Period from 60 days before to 60 days after it ends — roughly through March 1, 2027 — but any plan you pick after Jan. 1 starts later, on the first of the next month.
• 2027 numbers to know: out-of-pocket max $12,000 single / $24,000 family; HSA limits $4,500 / $9,000; every Marketplace Bronze and Catastrophic plan is HSA-eligible; median proposed premium increase about 15%.

Which insurers are leaving the ACA Marketplace after 2026

The table below combines healthinsurance.org’s Oct. 8 update with KFF’s Oct. 7 tracker. Enrollee counts are approximate and come from filings and reports made at different times, so treat them as orders of magnitude, not exact head counts.

Insurer	Leaving the Marketplace in	Enrollees affected (reported)	Notes
Cigna	AZ, CO, FL, GA, IL, IN, MS, NC, TN, TX, VA	~369,000	Leaving the individual market entirely, on- and off-exchange
Baylor Scott & White Health Plan	TX	~100,000	No Marketplace plans after 2026
CareSource	IN, OH, WV	~60,000 IN; 28,000+ OH; WV ~16,000 in 2025	Staying in NV, GA and WI
PacificSource	ID, MT, OR	~60,000 combined	Leaving all three states
Providence Health Plan	OR	~36,000 (end of 2025)	Ending most of its insurance business
Medica	IA, KS, OK	~13,000	UCare-branded plans in MN also end (merger)
Celtic / Ambetter (Centene)	DE, NH	~12,000 in NH	Delaware count not disclosed
Mending (formerly Taro Health)	ME, OK	~1,100 ME; ~7,000 OK	Stops offering health insurance
ConnectiCare Insurance Co.	CT	3,719	Off-exchange only in 2027, all new plans
Cox Health Plans	MO	n/a	Off-exchange only in 2027 (ICHRA focus)
Sunshine State Health Plan	FL	n/a	Members moved to an Ambetter plan if they don’t choose
UnitedHealthcare	GA	n/a	Georgia Marketplace only
Molina	IL, MS and others	n/a	Shrinking from 14 states to about six

Sources: healthinsurance.org (updated Oct. 8, 2026); KFF (Oct. 7, 2026); Healthcare Dive on Molina (July 23, 2026). “n/a” = not publicly disclosed.

Disclosed enrollee counts for insurers leaving the ACA Marketplace after 2026 total roughly 690,000 — and Molina, UnitedHealthcare (GA), Cox and Sunshine State haven’t published counts. Data: healthinsurance.org (Oct. 8) and KFF (Oct. 7). Chart: Dollar Lane (original).

Two details in that table matter more than the headline. First, an exit can be partial: CareSource stays in Nevada, Georgia and Wisconsin; Molina keeps a handful of states; Cox and ConnectiCare keep selling off-exchange, where no federal subsidy applies. Second, insurers also shrink service areas without leaving a state, so a carrier can still be “in” your state but not in your county. The only reliable test is the notice in your mailbox and the plan list for your ZIP code once window shopping opens.

Cigna: the biggest single exit

Cigna reported first-quarter on-exchange enrollment of more than 350,000 people, KFF notes, and said it will leave the individual market in 2027 because it saw little potential to grow its Marketplace business. Healthinsurance.org puts the 2026 count at about 369,000 across 11 states. Because Cigna is leaving both on- and off-exchange, every Cigna individual and family member in those states needs a new insurer for 2027 — not just a new plan.

Cigna’s Connecticut headquarters in Bloomfield (the former Connecticut General building). Cigna is leaving the individual market in all 11 of its Marketplace states for 2027 — about 369,000 enrollees. Photo: Sphilbrick / Wikimedia Commons, CC BY-SA 3.0.

In Colorado, the state exchange says Cigna coverage stays in place through Dec. 31, 2026, and affected customers qualify for a Special Enrollment Period until March 1, 2027 (Connect for Health Colorado). Healthinsurance.org reports that Colorado’s exchange has confirmed Cigna enrollees will not be placed into a new plan automatically. If you are one of them and you do nothing, you are uninsured on Jan. 1.

Who is coming in

Entries are thinner than exits, but they exist. Healthinsurance.org lists Colorado Access (four of Colorado’s nine rating areas), Aspirus Health Plan (Minnesota), AmeriHealth Caritas (Indiana and Ohio), Antidote Health (Texas and Georgia), CalOptima Health (California) and Peak Health (West Virginia) as joining their states’ Marketplaces for 2027. A new carrier isn’t automatically better, but it is one more option to price.

Despite the exits, very few people are stuck with a single company. In 2026, only 1% of HealthCare.gov enrollees had access to just one insurer’s plans, compared with more than a quarter in 2018, according to healthinsurance.org.

Why so many insurers are leaving now

Insurers describe the 2026–27 individual market as a “perfect storm,” and the numbers explain why. The enhanced premium tax credits that had kept net premiums low expired at the end of 2025. KFF says that drove Open Enrollment sign-ups down by more than a million from 2025 to 2026. Healthinsurance.org reports that only 19.2 million people had effectuated (paid-up) Marketplace coverage as of February 2026 — 17% below plan selections — and that average net premiums rose 58% in 2026 even after many people moved to cheaper metal levels.

When premiums jump, healthier people are the first to drop coverage. That leaves a smaller, sicker risk pool, which pushes costs per member up. Molina is the clearest example: its ACA membership fell from 655,000 at the end of 2025 to 283,000 in the second quarter of 2026 after it raised rates about 30%, and its CEO told investors the shift toward high-cost members was underestimated (Healthcare Dive, July 23, 2026). The company plans to concentrate its remaining ACA members in about six states next year.

Premiums are rising again for 2027 as a result. KFF’s analysis of 276 insurers found a median proposed increase of 15% — the second straight year of double-digit hikes, after a 20% median finalized increase for 2026. Weighted average proposed increases range from under 7% in states such as Vermont, Iowa and Utah to about 29% in Arizona, per healthinsurance.org.

What actually happens to your coverage on Jan. 1

The answer depends on where you bought the plan. This is the part most people get wrong.

If you bought through HealthCare.gov

HealthCare.gov says that if you have Marketplace coverage in December and don’t choose a plan or end coverage by Dec. 15, it will re-enroll you automatically. If your insurance company isn’t offering plans next year, “we’ll re-enroll you in a plan with a different insurance company” (HealthCare.gov: Renew, change, update or cancel your plan). You should get a letter from your current insurer and a separate Marketplace notice naming the plan you were matched with. CMS’s sample of that “cross-issuer” notice tells consumers they can pick a different plan, that they qualify for a Special Enrollment Period, and that they must report the coverage end date on their application to use it.

Healthinsurance.org explains that the matching protocol used in most states looks for the lowest-cost plan with the same metal level and product type (HMO, EPO, PPO or POS) as the plan that is ending. That keeps you insured. It does not check whether your oncologist, your kid’s pediatrician or your insulin is covered.

If you bought through a state-run exchange

Rules vary. Some state exchanges crosswalk members much like HealthCare.gov; Colorado has said Cigna enrollees will not be moved automatically. Oregon is switching from HealthCare.gov to its own Explore Health platform for 2027, so Oregon enrollees affected by the PacificSource and Providence exits also have to activate a new account. Read every message from your exchange this month and confirm in writing what happens if you take no action.

If you bought directly from the insurer (off-exchange)

No one will pick a replacement for you. Healthinsurance.org is blunt: if your carrier leaves and you don’t select a new plan by Dec. 31, you’ll be uninsured on Jan. 1, because the new policy won’t be retroactive. Off-exchange enrollees also miss out on premium tax credits, so it is worth checking whether you would qualify for a subsidy by switching to an on-exchange plan this year.

The deadlines that matter (HealthCare.gov states)

Date	What happens
Now – Oct. 31	Watch for your insurer’s discontinuation letter and the Marketplace notice naming your matched plan. Update your login, phone and email.
Nov. 1, 2026	Open Enrollment for 2027 starts. Update your application and compare plans.
Dec. 15, 2026	Last day to pick a plan for coverage starting Jan. 1. After this, HealthCare.gov may auto-enroll you in its matched plan.
Dec. 31, 2026	Your current plan ends. Keep paying premiums through December.
Jan. 1, 2027	Coverage starts in the plan you picked (or the auto-matched plan) if you paid the first premium. Deductibles reset.
Jan. 15, 2027	Open Enrollment ends. Plans chosen Dec. 16 – Jan. 15 start Feb. 1.
~March 1, 2027	End of the 60-day loss-of-coverage Special Enrollment Period for a plan that ended Dec. 31. Plans start the first of the month after you choose.

Sources: HealthCare.gov dates and deadlines; HealthCare.gov Special Enrollment Periods; Connect for Health Colorado (March 1, 2027 SEP end for Cigna members). State-run exchanges can set different windows — check yours.

The Special Enrollment Period is a real safety net. HealthCare.gov lists a discontinued individual or Marketplace plan as a qualifying loss of coverage, and you can use it if you lost coverage in the past 60 days or expect to lose it in the next 60 (HealthCare.gov: Special Enrollment Periods). You may have to upload documents proving the loss, so keep the insurer’s termination letter. But the SEP is a backup, not a strategy: if you were auto-assigned in January and switch on Feb. 5, healthinsurance.org notes, you keep the auto-assigned plan for January and February and the new one starts March 1 — with a fresh deductible.

Why you should pick your own replacement plan

Letting the Marketplace choose is better than going uninsured. It is rarely the best financial outcome. Here is what the matching algorithm cannot see:

• Your doctors and hospitals. A plan from a different company almost always means a different network. If you are mid-treatment, pregnant, or managing a chronic condition, this matters more than premium.
• Your prescriptions. Formularies differ. A drug on a low tier with Cigna may sit on a specialty tier — or need prior authorization — somewhere else.
• Your real total cost. The lowest premium at the same metal level can carry a higher deductible or out-of-pocket maximum. For 2027 the legal ceiling rises to $12,000 for one person.
• HSA eligibility. Every Marketplace Bronze and Catastrophic plan is HSA-eligible. If you’ve been saving in an HSA, you want to stay in a plan that keeps contributions legal.
• Silver-only cost-sharing reductions. If your income qualifies for CSRs, only a Silver plan delivers them. An auto-match that keeps you in Gold or Bronze can quietly cost you thousands in deductibles.

If you get coverage through work instead and are comparing plan types, our HDHP vs PPO break-even guide for 2027 uses the same logic: total yearly cost, not premium alone.

The 2027 numbers to plug in when you compare

Item	2026	2027	Source
Max out-of-pocket, self-only	$10,600	$12,000	CMS
Max out-of-pocket, family	$21,200	$24,000	CMS
Silver CSR out-of-pocket cap, 100%–200% FPL (self-only)	—	$4,000	CMS
Silver CSR out-of-pocket cap, 200%–250% FPL (self-only)	—	$9,600	CMS
HSA contribution limit (self / family)	$4,400 / $8,750	$4,500 / $9,000	IRS via healthinsurance.org
Median proposed premium change	+18% proposed / +20% final	+15% proposed	KFF
Share of 2026 OE enrollees with subsidies	87%	—	healthinsurance.org

CMS figures: Premium Adjustment Percentage and Maximum Annual Limitation on Cost Sharing for the 2027 Benefit Year (Jan. 29, 2026). The $12,000 cap is about 13.2% above 2026.

The $12,000 cap is a ceiling, not a typical plan

The out-of-pocket maximum is the most a plan can make you pay for in-network covered care in a year, including the deductible, copays and coinsurance. Many plans set lower limits; some Bronze plans sit right at the federal maximum. A plan rule that would have let some Bronze plans go as high as $15,600 was stayed by a court in July, so $12,000 is the highest single limit you should see for 2027. When you compare two plans, add 12 months of premium to the out-of-pocket maximum: that sum is your worst-case year. Then estimate a “normal” year using the deductible and the copays for the care you actually use.

Cost-sharing reductions change that math dramatically for lower-income households. At 100%–200% of the poverty level, a Silver plan’s out-of-pocket cap drops to $4,000 for one person — a third of the regular maximum. At 200%–250%, the cap is $9,600. If you qualify and get auto-assigned out of Silver, you lose that protection.

Subsidies follow the benchmark, not your old plan

Premium tax credits are calculated from the second-lowest-cost Silver plan in your area. When that benchmark rises, subsidies rise too — which is why healthinsurance.org expects many enrollees to be partly or fully shielded from 2027’s premium increases. But the benchmark can change when insurers leave. If the old benchmark carrier exits, the new second-cheapest Silver plan may be priced very differently, and your subsidy moves with it. The only way to know your net premium is to update your application and look at real quotes after Nov. 1. People who don’t get subsidies — including everyone who buys off-exchange — pay the full increase.

Remember that the enhanced subsidies that capped premiums for higher earners expired after 2025. If your household income is near 400% of the poverty level, small changes in income estimates can mean a large change in what you pay. Our Oct. 9 open-enrollment explainer covers that subsidy cliff in detail.

Bronze plans are HSA plans now

Under the 2025 tax law, Bronze and Catastrophic plans bought as individual coverage through an Exchange are treated as HSA-eligible starting in 2026 (IRS Notice 2026-5), and healthinsurance.org confirms that continues for 2027. That makes a Bronze replacement more interesting than it used to be. A single person who contributes the full $4,500 for 2027 and is in the 22% federal bracket saves about $990 in federal income tax, and HSA contributions also lower the modified adjusted gross income used for ACA subsidies — which can increase your premium tax credit. Contributions for 2027 are allowed until the April 2028 filing deadline. See our guides to HSA eligibility and limits and smart ways to use an HSA.

Step-by-step: replace a plan that’s ending

1. Confirm the notice. Find the letter from your insurer and, on HealthCare.gov, the Marketplace notice naming your matched plan. Write down the matched plan’s name and plan ID.
2. List what must stay covered. Every doctor, specialist, hospital, therapist and prescription (with dose) your household uses. This list drives everything else.
3. Check identity and login now. Healthinsurance.org warns that HealthCare.gov enrollees may face extra identity-verification steps for 2027. Fix passwords, phone numbers and emails before the Dec. 15 rush.
4. Estimate 2027 household income. Subsidies use your expected 2027 income, not last year’s. Include raises, side income and planned retirement withdrawals; subtract expected HSA and pre-tax retirement contributions.
5. Update your application on or after Nov. 1. Report that your current coverage ends Dec. 31 for each person on the letter. That is what unlocks the Special Enrollment Period as a backup.
6. Compare at least three plans. Include the matched plan, the cheapest plan that keeps your must-have doctors, and a Silver plan if you qualify for cost-sharing reductions. Add a Bronze plan if you want HSA eligibility.
7. Run worst-case and normal-year math. Worst case = 12 months of premium + out-of-pocket max. Normal year = premium + the care you used in 2026 priced under each plan’s deductible and copays.
8. Verify networks directly. Search the insurer’s 2027 directory, then call your key doctors’ billing offices and ask, “Will you be in network with [plan name] for 2027?” Directories are often wrong.
9. Enroll by Dec. 15 and pay the first premium. Coverage doesn’t start until the binder payment clears. Save confirmation numbers and screenshots.
10. Close the loop in January. Confirm ID cards arrive and give your pharmacy and doctors the new details.

Free help is available. Call the Marketplace Call Center at 1-800-318-2596 (TTY 1-855-889-4325) or find a local assister through HealthCare.gov. If you used an agent or broker, ask whether they are still certified for 2027 and whether they are paid by the plan they recommend.

Special situations

You’re in the middle of treatment

All ACA individual plans run on the calendar year, so your deductible would have reset on Jan. 1 anyway. The bigger risk is network disruption. Before you pick a plan, ask your specialist’s office which 2027 Marketplace plans they accept, and ask the new insurer about transition-of-care rules for ongoing treatment or prior authorizations. Get any pending authorizations, refills and procedures scheduled before Dec. 31 where it makes clinical sense.

You’re not a U.S. citizen

Starting with 2027 coverage, federal Marketplace subsidies are limited to lawful permanent residents, Cuban-Haitian Entrants and Compact of Free Association migrants. Refugees, asylees, people with Temporary Protected Status and people on work or student visas no longer qualify for federal subsidies, per healthinsurance.org. If that’s you, price full-cost Bronze plans and check for state programs.

You’re 30 or older and wanted a Catastrophic plan

A 2025 rule that widened Catastrophic plan eligibility was stayed by a judge in July 2026. For 2027, people 30 and older again need a hardship or affordability exemption, and the paperwork takes time. Start early if this is your plan.

You now have a job-based option

Losing an individual plan can also trigger a special enrollment right for an employer plan, under separate group-plan rules. If you or your spouse has an offer at work, compare it — our employer open enrollment guide walks through deductibles and FSA/HSA windows. Some employers now offer an individual-coverage HRA (ICHRA) instead; that requires calling the Marketplace to enroll.

You or a parent is turning 65

Medicare works differently, with its own Dec. 7 deadline. If a parent’s Medicare Advantage plan is also ending, see Your Medicare Advantage Plan Is Ending in 2027? for Medigap guaranteed-issue rights and the switching windows.

Mistakes that cost money

• Assuming “auto-renew” means “same plan.” When your insurer leaves, auto-renewal means a different company and probably a different network.
• Stopping premium payments in December. Your plan still covers you through Dec. 31. Miss a payment and you can lose coverage after the grace period — right before the switch.
• Waiting for the SEP. The 60-day window after Jan. 1 is a safety net, but each month you wait is a month in a plan you didn’t choose or a month uninsured.
• Comparing premiums only. A plan that costs $40 less a month can carry a deductible thousands higher. Use worst-case math.
• Not budgeting for the reset. A new plan means a new deductible on Jan. 1. Park a cash cushion for early-year care in your emergency fund.

FAQ

Will my current plan stop paying claims before Dec. 31?

No, not for the exits announced so far. Healthinsurance.org says all announced 2026 exits are scheduled for year-end, so 2026 coverage continues as long as you keep paying premiums. Mid-year insurer failures have been rare.

If I’m auto-enrolled, can I still change?

Yes. On HealthCare.gov you can pick a different plan by Dec. 15 for a Jan. 1 start, or by Jan. 15 for a Feb. 1 start. Because your old plan ended, you also have a loss-of-coverage Special Enrollment Period that runs about 60 days past Dec. 31.

Will I keep my subsidy?

If your circumstances haven’t changed, you should remain eligible, though you may have to re-verify information. The dollar amount will change because 2027 benchmark premiums are different, and your net cost depends on which plan you choose.

Does my deductible progress carry over?

No. ACA individual plans run on the calendar year, so every plan — new or renewed — starts at $0 on Jan. 1. That’s one reason a year-end exit is less disruptive than a mid-year one.

I’m in Colorado with Cigna. What’s different?

Healthinsurance.org reports that Colorado’s exchange won’t auto-enroll Cigna members into a new plan. Connect for Health Colorado says coverage lasts through Dec. 31 and the Special Enrollment Period runs until March 1, 2027. Pick a plan during Open Enrollment (Dec. 15 for a Jan. 1 start) so you’re not uninsured.

Bottom line

For 2027, the ACA Marketplace is losing insurers faster than it is gaining them: Cigna is leaving all 11 of its states (about 369,000 enrollees), and at least a dozen carriers are exiting some or all of 24 states, with disclosed counts alone near 690,000 people. Your 2026 plan works through Dec. 31, but after that you need a new insurer. HealthCare.gov will usually auto-assign one if you do nothing; Colorado says it won’t for Cigna members, and off-exchange buyers get no safety net at all. Update your application after Nov. 1, list your must-have doctors and drugs, compare at least three plans using worst-case math against the new $12,000 out-of-pocket cap, consider an HSA-eligible Bronze plan or a CSR Silver plan if you qualify, and choose by Dec. 15. The 60-day Special Enrollment Period through about March 1 is your backup — not your plan.