Cigna is leaving the ACA individual market in all 11 states where it sells Marketplace plans for 2027, and several other insurers are pulling out of individual states, from UnitedHealthcare in Georgia to Molina in Florida, Illinois and Ohio, according to KFF’s tracking of insurer participation and state regulators.
Health Plan News mapped the changes in eight of the largest states in new reference guides that list every Marketplace insurer for 2026 and 2027, the largest carriers by market share, Medicaid managed care plans and Medicare Advantage leaders. Start with Health Insurance Companies in Texas or Florida.
If your insurer is leaving, you will not be moved automatically to a plan you would choose. Pick a new plan by December 15 for coverage that starts January 1.
Who Is Leaving, State by State
- Texas: Baylor Scott & White Health Plan, Cigna and Moda leave. Baylor Scott & White covered about 100,000 Marketplace members, according to Becker’s.
- Georgia: UnitedHealthcare exits Georgia Access after state regulators pushed back on a requested 54% rate increase, and Cigna leaves.
- Ohio: CareSource and Molina leave, affecting about 54,000 enrollees, according to the Ohio Department of Insurance. AmeriHealth Caritas enters.
- Illinois: Cigna and Molina leave Get Covered Illinois, leaving five insurers statewide.
- Florida: Cigna and Molina leave. Florida Blue still sells in all 67 counties.
- Arizona: Cigna leaves, and UnitedHealthcare expands.
Not every state is shrinking. Covered California adds CalOptima Health in Orange County for 12 insurers in 2027, and Michigan’s lineup is unchanged.
Why Insurers Are Pulling Back
The expanded premium tax credits expired at the end of 2025, and Marketplace sign-ups fell in 41 states for 2026. The people who stayed tend to be older and sicker, which raises claims per member. Several insurers also reported higher-than-expected medical costs in the individual market.
Premiums keep climbing as a result. Illinois approved an average individual-market increase of 14.1% for 2027, after 28.8% for 2026, and Covered California’s preliminary average is 9.9%. In Georgia, exchange enrollment fell from about 1.3 million to about 900,000 by September, according to the Atlanta Journal-Constitution.
Fewer insurers usually means less price competition the following year.
One Insurer Often Dominates
The exits land in markets where one company often dominates. Blue Cross Blue Shield of Michigan holds 65% of that state’s commercial market, and Blue Cross and Blue Shield of Illinois 62%, according to the American Medical Association. Our Illinois and Michigan guides show the second-largest carriers trail far behind.
What To Do Next
- Open any notice from your insurer about 2027 coverage.
- Update your income on HealthCare.gov or your state exchange before comparing plans.
- Confirm your doctors are in the new plan’s network.
- Compare the out-of-pocket maximum, not just the premium; see our deductible vs out-of-pocket maximum guide.
- Check your new insurer’s claim denial record in our claim denial rankings.
The other state guides cover California, Ohio, Georgia and Arizona. Follow our Health Insurance Companies hub for more insurer changes during Open Enrollment.