If you buy your own health insurance, check the mail and your marketplace account now. KFF counts 11 insurers leaving at least one state’s ACA marketplace for 2027, against seven entering. The largest is Cigna, which is leaving the individual market entirely — on and off the exchange — in all 11 states where it sold plans, affecting well over 350,000 people. Molina, Medica, CareSource, PacificSource and several regional plans are pulling out of specific states.
Your current plan keeps working through December 31, 2026 as long as you pay premiums. What happens on January 1 depends on whether you act — and, if you don’t, on which marketplace you use.
Which Insurers Are Leaving Each State
| State | Leaving the marketplace for 2027 |
|---|---|
| Arizona | Cigna |
| Arkansas | Ambetter and QualChoice (Centene) |
| Colorado | Cigna |
| Connecticut | ConnectiCare Insurance Company (moving to off-marketplace plans only) |
| Delaware | Ambetter (Centene) |
| Florida | Cigna, Molina; Sunshine State Health Plan members move to Ambetter |
| Georgia | Cigna, UnitedHealthcare |
| Idaho | PacificSource |
| Illinois | Cigna, Molina |
| Indiana | Cigna, CareSource |
| Iowa | Medica |
| Kansas | Medica |
| Kentucky | Molina (reported in October exit trackers; confirm with your notice) |
| Maine | Mending (formerly Taro Health) |
| Minnesota | UCare plans end after Medica’s acquisition |
| Mississippi | Cigna, Molina |
| Missouri | Cox Health Plans (off-marketplace plans only) |
| Montana | PacificSource |
| New Hampshire | Ambetter (Centene) |
| North Carolina | Cigna |
| Ohio | CareSource, Molina |
| Oklahoma | Medica, Mending |
| Oregon | PacificSource, Providence Health Plan |
| South Carolina | Molina |
| Tennessee | Cigna |
| Texas | Cigna, Baylor Scott & White Health Plan |
| Utah | Molina |
| Virginia | Cigna |
| West Virginia | CareSource |
Compiled from KFF’s 2027 insurer participation tracker (updated October 28, 2026), healthinsurance.org’s exit list (updated October 20, 2026) and insurer announcements. Your insurer’s non-renewal letter is the final word for your plan.
What Happens If You Do Nothing
| Where you bought the plan | If you don’t pick a new one |
|---|---|
| HealthCare.gov states | If you haven’t chosen a plan by December 15, the marketplace generally re-enrolls you in a plan from a different insurer — matched on metal level and plan type, then the closest provider network, then the lowest premium |
| State-run marketplaces | Rules vary. Connect for Health Colorado has said Cigna enrollees will not be placed in a new plan automatically for 2027, so they must choose one |
| Bought directly from the insurer (off-exchange) | Nothing is automatic. Coverage ends December 31 and you are uninsured on January 1 unless you enroll in a new plan |
Even where automatic placement exists, treat it as a safety net, not a choice. The replacement is chosen by price band and metal level, not by your doctors or prescriptions, and your net premium will change because subsidies are recalculated for the new plan and the new year.
The Deadlines
| Date | What it means |
|---|---|
| November 1, 2026 | Open enrollment for 2027 opened on HealthCare.gov and most state marketplaces |
| December 15, 2026 | Choose a plan by this date for coverage starting January 1 (some state marketplaces allow later dates) |
| December 31, 2026 | Your current plan ends |
| January 15, 2027 | Open enrollment closes on HealthCare.gov; a plan chosen after December 15 starts February 1 |
| 60 days before and after your plan ends | Losing coverage because your insurer leaves also opens a special enrollment period, useful if you miss open enrollment or are switched automatically and want a different plan |
Coverage under a special enrollment period isn’t retroactive: if you enroll after December 31, the new plan starts the first of the following month and you’ll have a gap.
How to Pick the Replacement
- Check your doctors and hospitals in each candidate plan’s directory, and call the offices to confirm. Network type matters: many remaining plans are HMOs or EPOs with no out-of-network coverage.
- Enter your prescriptions in the plan comparison tool to see each formulary and tier.
- Update your 2027 income estimate. The premium tax credit depends on it, and above 400% of the federal poverty level there is no credit in 2027.
- Compare gold, not just silver. In many areas the cheapest gold plan now costs about the same as or less than benchmark silver — nationally $694 versus $703 a month for a 40-year-old in 2027 — while carrying a lower deductible.
- Consider bronze with an HSA if you’re healthy: since 2026 all individual-market bronze and catastrophic plans are HSA-eligible.
- Pay the first premium. A new plan with a new insurer doesn’t start until you pay its first bill.
Your deductible and out-of-pocket maximum reset on January 1 no matter what, so a year-end switch doesn’t cost you credit toward this year’s deductible. Prior authorizations and ongoing treatment are another matter: ask the new insurer about transition-of-care rules before you switch if you’re in the middle of treatment.
What the New Plan Will Cost
Benchmark premiums rose about 13% for 2027, to an average of $703 a month for a 40-year-old before subsidies, after a 26% increase for 2026. Each state guide linked in the table above shows that state’s 2027 benchmark by age and for a family of four, and the health insurance by state page compares all 50 states. Self-employed buyers can estimate the after-tax cost with the self-employed health insurance calculator. If you’re on Medicare and your Medicare Advantage plan is the one ending, the rules are different — see Medicare Advantage plan discontinued for 2027.
Frequently Asked Questions
Which health insurance companies are leaving the marketplace in 2027?
KFF counts 11 insurers exiting at least one state's ACA marketplace for 2027. Cigna is leaving all 11 of its states (Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia). Others include Molina, Medica, CareSource, PacificSource, Providence Health Plan, Baylor Scott & White Health Plan, Ambetter in some states, UnitedHealthcare in Georgia, Cox Health Plans in Missouri, ConnectiCare in Connecticut and Mending in Maine and Oklahoma.
What happens if my marketplace insurer leaves and I don't pick a new plan?
On HealthCare.gov, if you haven't chosen a plan by December 15 you are generally re-enrolled in a similar plan from a different insurer, matched on metal level, plan type, network and price. State-run marketplaces set their own rules, and Colorado has said Cigna enrollees will not be moved automatically for 2027. Plans bought directly from the insurer end on December 31 with no automatic replacement.
Do I get a special enrollment period if my insurer leaves?
Yes. Losing coverage because your plan is discontinued opens a special enrollment period from 60 days before to 60 days after the plan ends. Coverage chosen after December 31 starts the first of the following month, so choosing during open enrollment avoids a gap.
Is Cigna leaving the ACA marketplace in 2027?
Yes. Cigna is leaving the individual market on and off the exchange in all 11 states where it sold ACA plans, effective with the 2027 plan year. Members keep their current coverage through December 31, 2026 and need a new plan for January 1, 2027.
Will my deductible reset if I switch insurers?
ACA plans run on the calendar year, so deductibles and out-of-pocket maximums reset on January 1 whether or not you change plans. A year-end switch doesn't lose credit toward a deductible.
This content is for informational purposes only and does not constitute insurance advice. Insurer participation can change, and state-run marketplaces set their own re-enrollment rules and deadlines. Confirm with your insurer's notice, HealthCare.gov or your state marketplace, or a licensed agent or navigator.