ACA Market Sees Record Exodus and Price Jumps

The federal health insurance marketplace has entered its annual open enrollment period facing a dual crisis of rising costs and shrinking competition. The 2026 enrollment window opened on Saturday, November 1, 2026, under conditions that differ sharply from previous years. Consumers are currently navigating a system where fewer insurers offer plans, and those that remain have announced steep price increases.

Eleven insurance companies have announced they will withdraw from the Affordable Care Act marketplace. This exodus follows the expiration of pandemic-era subsidies that Congress did not renew. The loss of those subsidies drove premiums up significantly last year, which caused many enrollees to drop coverage. Those who stayed often switched to cheaper plans with lower quality, yet those plans still cost more than the subsidized versions they replaced.

The financial strain on providers has made the marketplace less profitable. Insurers that are staying in the market have raised prices by up to 15%. This marks the second year in a row that the exchange has seen double-digit increases in premiums. Cigna is among the providers leaving. A company spokesperson directed reporters to comments made by CEO Brian Evanko in April. Evanko stated that exiting the marketplace aligns with goals to position the company’s core healthcare businesses for sustainable growth.

Cynthia Cox, director of the program on the ACA at KFF, noted the imbalance in the market. She said, “The main takeaway is that more insurance companies are leaving the marketplace than coming in.” This trend reduces the number of options available to shoppers, which can limit access to specific doctors or hospitals that do not contract with the remaining insurers.

Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, warned of the practical consequences for patients. She said, “This is going to create a lot of discontinuities in care and coverage for people.” Yaver explained that if a patient’s doctor does not accept the fewer available plans, the transition can be disruptive. She added that this risk is especially high for individuals managing chronic illnesses who rely on continuous access to specific providers.

Yaver also questioned the sustainability of coverage for those who cannot afford the new price points. She asked, “And if the fewer available price points don’t work for you, are you going to remain covered?” For many working families, the answer is becoming increasingly difficult to determine as the gap between income and premium costs widens.

The user experience on the official enrollment website has also drawn criticism. The Trump administration has not prioritized maintenance of the platform, according to recent reports. Users have reported waiting up to 30 minutes to receive security codes to log in. Once inside the application, shoppers face a shorter list of plans than in prior years. The available options are generally more expensive, leaving fewer affordable choices for those on tight budgets.

One current enrollee described the financial impact of the changes. This individual pays approximately $185 per month for a bronze plan. That same plan will cost $322 per month in the new enrollment period. The increase represents a jump of over 70% for a tier of coverage that already offers limited benefits. For someone working two jobs, the added cost may make the plan unaffordable, forcing a choice between paying out of pocket or going without insurance.

The combination of fewer insurers, higher premiums, and technical issues with the enrollment platform creates a volatile environment for the 2026 open enrollment period. As the deadline for coverage approaches, the pressure on consumers to select a plan will intensify. The market dynamics suggest that the number of uninsured Americans may rise as the cost of coverage outpaces the budgets of working families.