Cigna Sez Sayonara: Another major carrier bailing on ACA exchanges next year

via Bruce Japsen of Forbes:

The Cigna Group disclosed plans to exit the individual health insurance business under the Affordable Care Act, also known as Obamacare, leaving about 369,000 health plan members in 11 states looking for new coverage in 2027.

The decision, disclosed Thursday, a day when Cigna reported $1.7 billion in first quarter net income, comes as more Americans can no longer afford Obamacare after the Republican-led Congress and the Trump administration failed to renew enhanced subsidies.

Already, enrollment in the individual plans Cigna sells dropped 17% to 369,000 in the first quarter compared to 446,000 in the first quarter of last year, the company said in its first quarter earnings report. Enrollment in Cigna’s individual coverage was flat when compared to the end of last year despite adding 20 new counties to the more than 370 counties across 11 states where the company has sold Obamacare.

It's important to note that this doesn't necessarily mean the same thing as overall ACA enrollment dropping 17%, since many of those enrollees presumably switched to a different carrier instead. However...

Across the health insurance industry, the end of enhanced tax credits is triggering an exodus of health plan members who either can no longer afford coverage or who are buying lower-priced “bronze” plans that carry high deductibles, industry analysts and companies have said.

Earlier this week, Centene, a much bigger player in Obamacare, said such enrollment tumbled by 2 million enrollees to 3.58 million at the end of the first quarter compared to 5.54 million at the end of last year and 5.62 million in the year ago quarter. UnitedHealth Group’s UnitedHealthcare last week said its Obamacare enrollment was down as well, falling to 1.4 million from 1.7 million last year. And a year ago, CVS Health announced plans to exit the individual health insurance business, leaving about 1 million Aetna members in 17 states looking for new coverage for this year.

So that's a 17% year over year drop for Cigna, a 36% year over year drop for Centene, and an 18% drop for UnitedHealthcare.

Across all three, that's a combined 31% drop in enrollment from 7,766,000 to 5,349,000 or over 2.4 million fewer enrollees across these three giants, which represented 35% of the total ACA market a year ago.

Again, while some of those 2.4M presumably moved to other carriers, my guess is that perhaps ~2 million or so of them have already been forced into dropping coverage altogether.

The big dip in enrollment and health insurer exits are what Democrats in Congress and health insurance industry analysts said would happen after Republicans in Congress and the Donald Trump White House wouldn’t agree to extend enhanced tax credits for buyers of Obamacare. A KFF analysis last fall said middle income Americans “as well as those with low incomes” will see “major out-of-pocket premium increases" if tax credits aren’t extended. And they are with customers reporting a doubling and even tripling of premiums for this year.

The subsidies, or tax credits, made health insurance premiums more affordable for individuals and were enhanced by the Biden administration and the Democratic-controlled Congress, which passed the Inflation Reduction Act of 2022, allowing more Americans to buy coverage. The enhanced subsidies helped enrollment in Obamacare eclipse a record 24 million Americans and drove its popularity to all-time highs.

...As insurers disclose falling enrollment or exits, it’s become clear that an additional 1 million+ enrollees (beyond what the Trump administration disclosed) are dropping coverage or can no longer afford it.

Gee, it's almost like someone has been shouting from the rooftops about exactly this for well over a year now...

For what it's worth, the 11 states which Cigna currently operates & is pulling out of include Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia.

While my enrollment data for Cigna in each of these states is a year out of date, it looks like the states which will be the most heavily impacted include Colorado, Mississippi, Tennessee & Virginia, where Cigna held anywhere between 12 - 18% of the total ACA market a year ago.

From my 2026 Rate Filing analysis project, it looks like as of March 2025, Cigna held the following enrollment; I don't know how much each of these shifted for 2026, but I'm guessing all of them are lower now:

• Arizona: ~2,500
• Colorado: ~56,000
• Florida: ~97,000
• Georgia: ~35,000
• Illinois: ~1,600
• Indiana: ~8,600
• Mississippi: ~53,000
• North Carolina: ~22,000
• Tennessee: ~89,000
• Texas: ~23,000
• Virginia: ~45,000
• Total: ~432,700