Courtney Mroch was already paying a high price for health insurance when she learned her insurer, Cigna, was pulling out of Tennessee’s Affordable Care Act marketplace.The 56-year-old Nashville resident has diabetes and asthma and is a cancer survivor.She pays $1,250 a month for a silver plan this year, up from $850 a month in 2025 — more than her family’s mortgage.
To keep costs down, her husband is enrolled in a separate, non-ACA plan that’s less expensive.“Who knows who will cover me in 2027 or how much more it’ll cost,” Mroch said.Many Americans are heading into ACA open enrollment with the likelihood of higher premiums and fewer insurance companies to choose from.
In most states, the enrollment period begins Sunday, giving people who buy their own coverage about two months to compare plans for next year.Insurers who offer ACA plans are proposing a premium increase of about 15%, on average, for 2027 — the second straight year of double-digit increases, according to an analysis from KFF, a nonpartisan health policy research group, that looked at public filings from insurers across all 50 states and Washington, D.C.At the same time, 11 insurers have announced plans to leave the ACA marketplaces in 2027 in at least some states where they currently offer coverage, according to KFF.
Among them is Cigna, which will exit all 11 states where it offers ACA plans and has more than 350,000 ACA enrollees.Six insurers have announced plans to enter new marketplaces.
“The main takeaway is that more insurance companies are leaving the marketplace than coming in,” said Cynthia Cox, director of the program on the ACA at KFF.For people shopping for coverage, that could mean fewer insurers to choose from and more people having to switch plans.“This is going to create a lot of discontinuities in care and coverage for people,” said Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh.“If you have a doctor...