Cigna Is the Latest To Exit ACA Market As Subsidies Shrink

BY ANNA WILDE MATHEWS

Cigna Group will exit the Affordable Care Act market next year, the latest sign of turmoil in a business that has been hit hard by the loss of federal subsidies.

Cigna will be the second major health insurer to leave the ACA market, after CVS Health’s Aetna stopped offering plans at the start of this year.

ACA policyholders are dropping their coverage because of increasing monthly bills, after the January phaseout of higher federal subsidies that started during the pandemic. Insurers and actuaries are projecting that overall ACA enrollment could fall by as much as a quarter this year.

Last year, there were around 24 million people enrolled in ACA plans. Registrations fell to 23 million for 2026, and attrition since then has been steep, as people failed to make premium payments during an initial grace period.

The ACA markets are politically sensitive, because voters have focused on healthcare costs as a major source of financial pain. Democrats, who pushed for the extension of the higher ACA subsidies, which they first passed in 2021, are expected to highlight the issue in this year’s midterm elections.

Instability in the ACA market presents a challenge for insurers, which are starting to propose rates for 2027 ACA plans in filings with state regulators. Younger, healthier people are more likely to end their coverage when monthly bills go up, leaving a greater proportion of sicker policyholders who have bigger healthcare costs. Insurers will typically raise their rates to cover higher average projected spending.

As the ACA population continues to decline, insurers may struggle to predict where next year’s rates should land—and cautiously request big premium increases, a dynamic that could push even more people out of the market in the future. ACA premiums already rose sharply in many states this year. For Cigna, the ACA is a small share of the company’s overall business, but the company is a l o n g t i m e player, with around 369,000 enrollees across 11 states.

Brian Evanko, the company’s president and incoming chief executive, said Cigna didn’t see a way to scale the ACA business to a size that would make a meaningful impact on the company’s results. The company has said its enrollment dropped 17% compared with the year-earlier quarter. Like other insurers, Cigna raised premiums in 2026.

In congressional testimony earlier this year, Cigna said it lost money in the ACA business in all but two years since 2014, the year the market began.

Sign-ups, in millions, for ACA plans this year, down from 24 million in 2025.