Insurers flee healthcare markets ahead of open enrollment

With open enrollment periods largely underway, many people are facing a stark reality when it comes to getting healthcare: A slew of insurers are vanishing from marketplaces, most notably the Affordable Care Act exchange. This could leave many without coverage options for 2027.

At least 11 insurers fleeing

The ACA, or Obamacare, is at the center of the insurer pullouts as they “reassess the profitability of their marketplace participation,” said health policy organization KFF. At least 11 insurers have announced plans to leave the ACA marketplace in 2027. This includes major companies like UnitedHealth, PacificSource and Cigna; the latter, which has over 350,000 ACA enrollees, will “exit the 11 states in which it currently participates both on- and off-exchange.”

The ACA isn’t the only target. Other insurers believe that “flat Medicare Advantage rates as proposed by the Trump administration” would “likely force them to take a deep look at the benefits they offer,” said industry outlet Fierce Healthcare. The funding changes at a “time of sharply rising medical costs and high utilization of care will impact seniors’ coverage,” Chris Bond, a spokesperson for insurance lobby AHIP, said in a statement per the outlet.

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Creating ‘discontinuities in care’

This insurer exodus could lead to problems for sick people, especially lower-income Americans. If someone has a “doctor who doesn’t accept the fewer number of options that are available to you, that can be very disruptive, especially if you’re someone who has a chronic illness,” Miranda Yaver, a professor of health policy and management at the University of Pittsburgh, told NBC News. “This is going to create a lot of discontinuities in care and coverage for people.” These changes also mean “constant upheaval, whether it’s the plan pulling out or the subsidies have changed or the doctor network has changed,” insurance broker Jennifer Chumbley Hogue said to the outlet.

These withdrawals ultimately “reflect a familiar cycle,” said industry outlet healthinsurance.org. Insurer participation in various markets has long been “cyclical over time, generally increasing when the individual market was healthier and larger and decreasing when it was sicker and smaller.” Decisions on what plans to offer are primarily “driven by insurers’ assessment of profitability and overall market stability.”