Is Your Health Insurance Company Leaving in 2027? What Exit Letters Mean
At least a dozen insurers have announced they're leaving or sharply shrinking their ACA marketplace footprint for 2027, affecting hundreds of thousands of enrollees in more than 20 states — and if yours is one of them, a discontinuation letter is headed to your mailbox this fall. That letter isn't a crisis, but it is a deadline. Here's what's happening, why, and exactly what to do so you don't get auto-assigned to a plan that doesn't fit.
Quick Answer: What an Exit Letter Means
If your insurer is leaving the marketplace for 2027, your coverage continues through December 31, 2026 — nothing changes mid-year. You'll get a legally required discontinuation letter in the fall, and you'll need to pick a new plan during Open Enrollment (November 1 – December 15, 2026 for January 1 coverage). If you do nothing, the marketplace may auto-map you to a "similar" plan from another insurer — but that plan can have a different network, drug list, and price, so never accept the auto-assignment blindly.
Which Insurers Are Leaving for 2027
As of September 2026, at least a dozen insurers have announced full or partial marketplace exits for plan year 2027, affecting hundreds of thousands of enrollees in more than 20 states:
- Cigna — leaving entirely: all 11 states where it sells individual plans (AZ, CO, FL, GA, IL, IN, MS, NC, TN, TX, VA), roughly 369,000 enrollees
- Molina Healthcare — shrinking from 14 states to six, including exits in Ohio, Indiana, West Virginia, Illinois, and Mississippi
- CareSource — exiting Indiana, Ohio, and West Virginia (about 90,000 enrollees)
- Baylor Scott & White — leaving Texas (about 100,000 enrollees)
- Medica — exiting Iowa, Kansas, and Oklahoma
- PacificSource — exiting Oregon, Idaho, and Montana
- Providence Health and Mending (formerly Taro Health) — also exiting their marketplace states
And that list may grow. States are still finalizing rate and participation approvals, so more exit announcements could land through the fall. If you haven't heard from your insurer yet, that's not a guarantee they're staying — watch your mail closely between September and November.
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Why Insurers Are Pulling Out
The short version: the math changed. The enhanced premium tax credits — the extra subsidies that made coverage cheaper for millions of people — expired at the end of 2025. When prices went up, enrollment dropped by millions, and the people most likely to drop coverage were the healthier ones who felt they could risk going without. That left insurers with a smaller, sicker risk pool: fewer customers, higher average medical costs per customer.
Insurers responded the way you'd expect — by asking for more money. The median premium increase for 2027 is around 15%, and roughly half of states have already finalized rates near that level. But for some carriers, even a double-digit rate hike didn't make the business work, so they're choosing to leave the marketplace entirely instead. It's not personal, and it's not about your claims — it's a market-level decision made state by state.
What Actually Happens to Your Coverage
An insurer exit unfolds on a predictable timeline, and the most important thing to know is that nothing happens to your coverage mid-year:
- Your current plan stays fully in force through December 31, 2026 — same benefits, same network
- Your insurer must send you a discontinuation letter in the fall — it's legally required, not optional
- If you do nothing, the marketplace may "crosswalk" you — auto-assign you to a plan from another insurer it considers similar
- If you somehow miss Open Enrollment, losing coverage because your insurer exits generally qualifies you for a Special Enrollment Period
The Problem With Auto-Assignment
Crosswalking sounds convenient — you're never left uninsured, and you don't have to lift a finger. But the mapped plan is chosen by a matching formula, not by anyone who knows your doctors, your medications, or your budget. The "similar" plan can have a different provider network, a different drug formulary, and a different price — sometimes all three. People who accept the auto-assignment blindly are the ones who discover in February that their specialist is out of network or their prescription moved to a pricier tier. Treat the crosswalk as a backstop, never as a decision.
Your Action Plan: Letter to New Plan
- Read the letter, then calendar the deadline. It's a deadline, not a crisis. Open Enrollment starts November 1, 2026, and you need to enroll by December 15 for January 1 coverage.
- List your must-haves. Write down your doctors, hospitals, and every prescription you take. This list is your scorecard for any replacement plan.
- Check networks and drug lists first. Before you compare a single premium, confirm each candidate plan covers your doctors and medications. A cheap plan that excludes your cardiologist isn't cheap.
- Compare every carrier — not just the "closest match." The plan the marketplace maps you to is rarely the best deal in your county. With carriers exiting and rates shifting, the whole lineup is different for 2027.
- Enroll actively before December 15. Even if you'd end up in the crosswalk plan anyway, choosing it deliberately means you've verified it actually fits.
Don't let the auto-assignment choose for you
The single biggest mistake people make when an insurer exits is doing nothing and accepting whatever plan they're mapped into. Fifteen minutes of comparison shopping — or a free call with a licensed advisor who can map your current benefits against every plan in your county — can save you from a year of the wrong network and the wrong drug list.
Frequently Asked Questions
Which health insurance companies are leaving the marketplace in 2027?
As of September 2026, at least a dozen insurers have announced full or partial exits for plan year 2027. Cigna is leaving the marketplace entirely — all 11 states where it sells individual plans, covering roughly 369,000 enrollees. Molina is shrinking from 14 states to six. CareSource is exiting Indiana, Ohio, and West Virginia (about 90,000 enrollees); Baylor Scott & White is leaving Texas (about 100,000); Medica is exiting Iowa, Kansas, and Oklahoma; and PacificSource is leaving Oregon, Idaho, and Montana. Providence Health and Mending (formerly Taro Health) are also exiting. More announcements could still come as states finalize approvals.
Why are insurers leaving the ACA marketplaces?
The enhanced premium tax credits expired at the end of 2025, enrollment dropped by millions, and the people who stayed tend to have higher medical costs — a sicker risk pool. Insurers are raising premiums a median of about 15% for 2027, and some decided leaving certain markets made more sense than raising rates and hoping enough healthy customers stayed.
What happens to my coverage if my insurer exits?
Your coverage doesn't disappear overnight. Your current plan continues through December 31, 2026, and your insurer is legally required to send you a discontinuation letter in the fall. You'll need to pick a new plan during Open Enrollment for coverage starting January 1, 2027.
What is a crosswalk or auto-assignment?
If your plan is discontinued and you do nothing, the marketplace may 'crosswalk' you — automatically mapping you to a plan from another insurer that it considers similar. It's a safety net, not a recommendation. The mapped plan can have a different provider network, drug formulary, and price, so you should always review it rather than accepting it blindly.
When do I need to act?
Open Enrollment starts November 1, 2026. Enroll by December 15, 2026 for coverage that begins January 1, 2027. Treat your discontinuation letter as a deadline, not a crisis — you have time to shop, but don't let it slide past mid-December.
What if I miss Open Enrollment?
Losing coverage because your insurer exits the market generally qualifies you for a Special Enrollment Period, so you'd still have a window to enroll. But relying on that backup means risking a gap in coverage — it's much cleaner to enroll during Open Enrollment.
Will my new plan cover my doctors and prescriptions?
Not automatically. Networks and drug lists vary by insurer, so a replacement plan — even one marketed as the closest match — may not include your current doctors or medications. Before enrolling, check each plan's provider directory and formulary for your specific doctors and prescriptions.
Do I have to pay for help choosing a replacement plan?
No. Licensed advisors can compare your current plan's benefits against everything available in your county — networks, drug coverage, and total costs — at no cost to you. Advisors are paid by insurers, so the price you pay is the same either way.
Insurer Leaving? Find Your Replacement Plan
If your insurance company is exiting for 2027, you don't have to sort through the replacement options alone. Our licensed advisors can map your current plan's benefits — network, drug coverage, and costs — against everything available in your county, and help you enroll before the December 15 deadline. It's free.
About This Guide: Created by the Health Insurance Network team to explain what happens when an insurer exits the ACA marketplace. Exit announcements and state approvals are still in progress for 2027, so details may change — confirm specifics with your insurer and your state's marketplace. We update this guide as new announcements are made.
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