Cigna to Withdraw from ACA Exchanges by 2027, Affecting 369,000 Enrollees

Cigna has announced its intention to withdraw from the Affordable Care Act (ACA) exchanges by 2027, impacting 369,000 enrollees. During Cigna's latest earnings call, the company reported a first-quarter net income of $1.7 billion. Despite this financial success, Cigna's leadership clarified that the ACA exchange business does not fit with their strategic long-term goals.

The decision to exit the ACA marketplace echoes similar actions by other major insurers such as Aetna, increasing the challenges for exchanges already adjusting to the expiration of enhanced federal subsidies. Brian Evanko, president and incoming CEO of Cigna, emphasized, “We did not make this decision lightly,” and assured a smooth transition for current enrollees. The company faced difficulties in scaling the ACA segment significantly within their overall business strategy.

Cigna’s enrollee numbers have declined by 17% from 446,000 in early 2025 to the current 369,000, underscoring a downward trend. Evanko noted, “This is small business for us today, and it’s been shrinking in recent years.” Additionally, with the lapse of enhanced federal subsidies, the ACA marketplace faces broader challenges as approximately 1.2 million fewer individuals have signed up for coverage. Rising premiums deter younger, healthier consumers, leaving insurers with a higher proportion of high-cost patients, further pushing premiums up.

While current market adjustments have not caused disruptions as severe as those in 2017, the issue of affordability remains crucial and is expected to shape future policy discussions. The insurance industry's navigation through regulatory compliance requirements and adaptation to evolving market dynamics will be key in maintaining stability within the ACA exchanges.