A major shift in the health insurance market is unfolding as Cigna prepares to step away from the Affordable Care Act marketplace, leaving 369,000 enrollees at the center of growing uncertainty as costs continue to rise.
The company confirmed it will exit the ACA exchanges in 2027, a decision announced during its latest earnings call where it also reported $1.7 billion in first-quarter net income. While the financials came in strong, executives made it clear the exchange business no longer fits into the company’s long-term strategy.
Cigna now joins Aetna as one of the latest major insurers to pull back from the marketplace, adding pressure to a system already adjusting to the loss of enhanced federal subsidies.
“We did not make this decision lightly, and appreciate the importance of ensuring patients have continuity through the transition,” said Brian Evanko, the company’s president and incoming CEO.
Evanko pointed to a lack of a “clear path” to scale the ACA segment into something meaningful for the company’s bottom line. Enrollment has already been trending downward, falling 17 percent from 446,000 in early 2025 to 369,000 this year.
“This is small business for us today, and it’s been shrinking in recent years,” Evanko said.
The broader marketplace is also shifting. After Congress allowed enhanced subsidies to expire, roughly 1.2 million fewer people signed up for coverage. As premiums rise, younger and healthier individuals are more likely to drop plans, leaving insurers with higher-cost patients and forcing rates even higher.
While the current exits have not triggered the same level of disruption seen in 2017, affordability is quickly becoming a central issue and could play a major role in upcoming elections.
