Cigna Withdraws from ACA Exchanges in 2027: Impacts and Insights

Cigna has announced its planned withdrawal from the Affordable Care Act (ACA) exchanges in 2027, as revealed during the company's recent earnings call. This exit is driven by the reduction in federal subsidies that previously bolstered marketplace participation. The decision aligns Cigna with CVS's Aetna, which also discontinued offering ACA plans earlier.

Brian Evanko, Cigna's current president and soon-to-be CEO, emphasized the difficulty of this decision, stressing the importance of ensuring a smooth transition for affected members. Evanko noted the challenges in expanding the ACA business to a scale that substantially impacts Cigna’s financial performance. The withdrawal will affect approximately 369,000 members across 11 states, a small portion of the company's total 18.3 million membership.

Cigna's ACA enrollment has experienced a 17% decrease, dropping from 446,000 enrollees in early 2025 to 369,000 in 2026. “This is a relatively small business for us, and it has been diminishing over the past years,” Evanko stated. The broader ACA enrollment has declined following Congress's decision not to extend enhanced subsidies, which lowered premiums and significantly impacted lower-income individuals.

The Trump administration attributes the declining enrollment numbers to efforts aimed at reducing fraud, suggesting that some losing coverage may not have qualified initially. Insurers now face the challenge of incorporating this uncertainty into premium calculations, potentially resulting in increased rates. Younger, healthier individuals may opt out when premiums rise, leaving a higher-cost pool of sicker policyholders, likely leading to further rate hikes.

Despite the exit of Cigna and Aetna from the exchanges, the current landscape does not echo the disruptions of 2017, where some regions lacked ACA plans. However, issues of affordability and healthcare costs remain significant, possibly influencing electoral discussions in the near future.