Cigna announced it will exit the Affordable Care Act (ACA) marketplace beginning in 2027, marking a significant shift in the individual insurance market. The decision makes Cigna the second major insurer to withdraw from the exchanges, following a similar move by Aetna, and reflects growing uncertainty about the future of ACA plans.
Company executives revealed the decision during an earnings call in which Cigna reported strong financial performance, including $1.7 billion in net income for the first quarter. Despite those results, leadership said the ACA segment no longer fits the company’s long-term strategy. President and incoming CEO Brian Evanko explained that the exchange business represents a small and shrinking portion of Cigna’s overall operations, with no clear path to meaningful growth.
Cigna’s withdrawal will impact approximately 369,000 members across 11 states. Enrollment in its ACA plans has already declined significantly, dropping from about 446,000 in early 2025 to 369,000 in 2026—a decrease of nearly 17%. This trend reflects broader challenges in the marketplace, particularly after the expiration of enhanced federal subsidies that had made coverage more affordable for millions of Americans.
The end of those subsidies has led to rising premiums and declining enrollment across the ACA system. About 1.2 million fewer people enrolled this year, and analysts expect further drops as costs increase. Without financial assistance, many individuals—especially younger and healthier ones—may opt out of coverage, leaving insurers with a higher-risk pool of enrollees. This dynamic can drive premiums even higher, creating a cycle that further destabilizes the market.
While current conditions are not as severe as in 2017—when some regions risked having no insurers at all—concerns about affordability and long-term sustainability remain central. The Trump administration has partly attributed enrollment declines to efforts to reduce fraud, suggesting some individuals losing coverage may not have been eligible.
The future of the ACA marketplace is likely to remain a key political issue. Democrats have criticized the decision not to extend subsidies, while Republicans argue that structural weaknesses in the system are to blame.
Cigna stated it will work to ensure a smooth transition for its members ahead of its 2027 exit, but its departure underscores ongoing challenges facing the ACA marketplace.
