Courtney Mroch was already paying a high price for health insurance when she learned her insurer, Cigna, was pulling out of Tennessee\u2019s Affordable Care Act marketplace.<\/p>\n
The 56-year-old Nashville resident has diabetes and asthma and is a cancer survivor. She pays $1,250 a month for a silver plan this year, up from $850 a month in 2025 \u2014 more than her family\u2019s mortgage. To keep costs down, her husband is enrolled in a separate, non-ACA plan that\u2019s less expensive. <\/p>\n
\u201cWho knows who will cover me in 2027 or how much more it\u2019ll cost,\u201d Mroch said.<\/p>\n
Many Americans are heading into ACA open enrollment with the likelihood of higher premiums and fewer insurance companies to choose from. In most states, the enrollment period begins Sunday, giving people who buy their own coverage about two months to compare plans for next year.<\/p>\n
Insurers that offer ACA plans are proposing a premium increase of about 15%, on average, for 2027 \u2014 the second straight year of double-digit increases, according to an analysis from KFF<\/a>, a nonpartisan health policy research group, that looked at public filings from insurers across all 50 states and Washington, D.C. <\/p>\n At the same time, 11 insurers have announced plans to leave the ACA marketplaces in 2027 in at least some states where they currently offer coverage, according to KFF<\/a>. Among them is Cigna, which will exit all 11 states where it offers ACA plans and has more than 350,000 ACA enrollees. Six insurers have announced plans to enter new marketplaces. <\/p>\n \u201cThe main takeaway is that more insurance companies are leaving the marketplace than coming in,\u201d said Cynthia Cox, director of the program on the ACA at KFF.<\/p>\n For people shopping for coverage, that could mean fewer insurers to choose from and more people having to switch plans.<\/p>\n \u201cThis is going to create a lot of discontinuities in care and coverage for people,\u201d said Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh. \u201cIf you have a doctor who doesn\u2019t accept the fewer number of options that are available to you, that can be very disruptive, especially if you\u2019re someone who has a chronic illness.\u201d <\/p>\n \u201cAnd if the fewer available price points don\u2019t work for you, are you going to remain covered?\u201d she added.<\/p>\n Why are insurers leaving?<\/p>\n The departures come after the enhanced tax credits expired at the end of 2025, leading ACA enrollment to fall by roughly 3 million.<\/p>\n