Cigna’s exit adds to ObamaCare marketplace upheaval

 Cigna is pulling out of the Affordable Care Act (ACA) exchanges in 2027, the company said, adding to the turmoil facing the individual marketplace after the loss of enhanced federal subsidies. 

Executives announced the decision on Cigna’s earnings call Thursday, a day when the company reported a better-than-expected first quarter, including $1.7 billion in first quarter net income. 

Cigna is now the second company to exit the ACA marketplace, after CVS’s Aetna stopped offering plans for this year. 

“We did not make this decision lightly, and appreciate the importance of ensuring patients have continuity through the transition,” said Brian Evanko, the company’s president and incoming chief executive.  

Evanko said he didn’t see a “clear path” to scale the ACA business to a size that would achieve a meaningful impact on the company’s bottom line. Cigna’s ACA footprint is a small portion of its overall market share; the decision to exit the exchanges will impact 369,000 members across 11 states. The company has 18.3 million total members. 

But its enrollment dropped 17 percent compared to the first quarter of 2025 — 369,000 in 2026 compared to 446,000 in 2025. 

“This is small business for us today, and it’s been shrinking in recent years,” Evanko said.  

Overall ACA enrollment dropped this year after Congress failed to extend enhanced subsidies that help reduce premiums for many enrollees. The subsidies made insurance free for the lowest-income customers and helped reduce premiums for people who earned more than about $63,000 per year.

Initial sign-ups had already fallen by about 1.2 million people, and those numbers are likely to grow as more people see unaffordable bills and can’t pay. 

The Trump administration has argued that the decline in enrollment is due to a crackdown on fraud, and the only people dropping coverage shouldn’t have been enrolled to begin with.

Insurers will have to price the uncertainty into their rates, leading to potentially even higher premiums. The people most likely to end their coverage when bills rise are younger and healthier. That leaves sicker policyholders with more expensive medical costs, leading insurers to raise rates to cover the higher spending. 

So far, the exit of two plans from the marketplace has not raised the same concerns as 2017, when some counties had no ACA plans amid upheaval. But affordability and the rising cost of healthcare are top issues for voters, and the issue is likely to feature prominently in the midterm elections.  

Democrats hammered Republicans earlier this year for failing to agree to an extension of the enhanced subsidies, and those attacks will likely intensify as November approaches. 

https://thehill.com/policy/healthcare/5859943-cigna-leaving-aca-exchanges/