The Affordable Care Act (ACA) is facing significant challenges as eleven insurers prepare to exit some state marketplaces in 2027, raising concerns over increased premiums and reduced options for consumers. This situation is particularly alarming for individuals and families who rely heavily on these plans, especially those with chronic health conditions. Among them is Courtney Mroch from Nashville, who has already seen her monthly premium rise from $850 to $1,250, a cost that now exceeds her family’s mortgage.
Mroch, who has diabetes, asthma, and is a cancer survivor, expressed anxiety about what the future holds for her health coverage. “Who knows who will cover me in 2027 or how much more it’ll cost,” she lamented. The impending open enrollment period, starting this Sunday, offers a limited window for families to evaluate their insurance options amidst these rising costs.
According to an analysis by KFF, a nonpartisan health policy group, insurers are proposing an average premium increase of approximately 15% for 2027, marking a trend of double-digit hikes for the second consecutive year. Simultaneously, the departure of eleven insurers, including major player Cigna, could lead to fewer choices for consumers. Cigna’s exit affects over 350,000 enrollees across eleven states, while six new insurers plan to enter the market.
Experts indicate that the trend of insurers withdrawing is concerning, as it could result in significant disruptions in care for people reliant on specific providers that may not accept the remaining plans. “This is going to create a lot of discontinuities in care and coverage for people,” noted Miranda Yaver, a health policy professor at the University of Pittsburgh.
The reasons for these withdrawals are tied to the expiration of enhanced tax credits at the end of 2025, which led to a decrease in ACA enrollment by roughly 3 million people. Many healthier individuals opted for cheaper plans with less coverage or dropped their insurance entirely, leaving those with higher medical needs behind. This shift is making the marketplace less profitable for insurers, creating a cycle that could discourage future participation.
As rising costs and limited options threaten the viability of the ACA, public support may continue to dwindle. A recent KFF poll indicated a drop in favorability towards the ACA from 64% to 58%. “We don’t see the repeal and replace of 2017, but we’re making it much harder for patients to remain on these plans,” Yaver warned.
For families like the O’Connors in Colorado, who have seen their premiums more than double, the future is uncertain. Denise O’Connor mentioned that her husband is contemplating going uninsured for a brief period until he qualifies for Medicare, highlighting the tough decisions many are forced to make in light of escalating healthcare costs.
Insurance brokers are urging consumers to actively explore their options during the upcoming enrollment period rather than rely on mailed notices, which may not reflect current pricing or subsidy information. “It’s worth the five minutes to take a look,” advised Jennifer Chumbley Hogue, an insurance broker in Texas.
Photo credit: Joe Raedle
