CVS Health’s Aetna to Exit ACA Marketplaces in 17 States by 2026

CVS Health's Aetna division will exit the Affordable Care Act (ACA) marketplace by 2026, impacting approximately one million members across 17 states. This strategic withdrawal reflects CVS Health's shift toward focusing on more profitable health services amid rising healthcare costs. Aetna's ACA plans currently represent a small portion of CVS Health's total membership but their removal signals significant changes for individuals relying on these plans for affordable coverage.

Affected states where Aetna plans will no longer be offered include Arizona, Arkansas, Colorado, Florida, Georgia, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, Ohio, Pennsylvania, and Virginia. Members in these regions will need to secure alternate health insurance during the 2026 open enrollment period.

The Aetna ACA exit coincides with a broader CVS Health initiative to reduce its retail footprint by closing over 900 stores nationwide by 2025, including at least 20 closures in Arkansas, motivated in part by regulatory compliance with Arkansas House Bill 1150. This legislation prohibits pharmacy benefit managers (PBMs) like CVS Caremark from owning retail pharmacies within the state, prompting divestitures or shutdowns.

Financially, CVS reported strong Q1 2025 results with $1.8 billion in net income, attributing success to cost-saving measures and restructured leadership. However, this financial performance is balanced against reduced patient access and coverage as stores close and health plan options shrink. CVS communicates a strategic shift toward high-value care experiences and expanded wellness services.

The combined contraction of retail locations and withdrawal from Medicaid marketplaces may create gaps in patient access, especially in vulnerable communities. Industry stakeholders will monitor how these moves impact health insurance market dynamics and patient care accessibility in affected states.