ACA premiums average 15% hike as 11 insurers exit markets

American health insurance shoppers begin a two-month window to select plans for 2027, facing an average premium increase of 15 percent. This marks the second consecutive year of double-digit hikes, according to a review of public filings by the Kaiser Family Foundation. At the same time, the number of available insurers is shrinking. Eleven companies have announced plans to leave ACA markets in at least some states next year.

The reduction in carrier options directly impacts individuals with chronic conditions who rely on specific provider networks. Courtney Mroch, a 56-year-old resident of Nashville with diabetes and asthma, pays $1,250 per month for a silver-level plan. That figure represents a jump from $850 in 2025. To manage expenses, her husband enrolled in a standalone plan outside the ACA. Mroch expressed uncertainty about who will provide coverage in 2027 and what the costs will be.

Cigna, one of the major carriers exiting the market, will withdraw from all 11 states where it currently sells ACA plans. The company serves more than 350,000 enrollees through the marketplace. Cynthia Cox, director of the ACA program at KFF, noted that the primary trend involves more companies leaving the sector than entering it. Six insurers have announced plans to enter new markets, but the net result is a reduction in competition.

The exodus follows the expiration of enhanced tax credits at the end of 2025. That change caused ACA enrollment to drop by approximately 3 million people. Healthier individuals shifted to cheaper, lower-quality plans or dropped coverage entirely. Consequently, the remaining pool of enrollees has higher average healthcare needs and costs, reducing profitability for insurers.

Jennifer Chumbley Hogue, a Texas insurance broker, described the current environment as one of constant agitation. She cited plan withdrawals, subsidy changes, and network shifts as factors that disrupt coverage. Miranda Yaver, an associate professor of health policy at the University of Pittsburgh, warned that these disruptions could lead to gaps in care. She stated that patients with chronic diseases are particularly vulnerable if their doctors are no longer in the reduced network.

Financial strain is visible in specific cases across the country. Denise O’Connor and her husband in Colorado saw their monthly premiums rise from slightly over $900 to approximately $2,300 this year. They used retirement savings to cover the difference. Mark Lathrop in Idaho faces a similar challenge after PacificSource decided to leave the market. A comparable plan for 2027 would cost him about $17,600, up from $16,000 last year. He requires an annual MRI that costs $2,400, making a lower deductible essential.

Public support for the ACA has declined alongside the rising costs and reduced options. A recent KFF survey found that favorable ratings for the law dropped to 58 percent from 64 percent. Yaver suggested that these market shifts are making it harder for patients to stay in plans without requiring legislative action to repeal the law. Insurers attribute their decisions to the need for sustainable growth. Cigna cited a desire to position its core health businesses for long-term success. PacificSource stated its exit was necessary to maintain its mission amid industry pressures.