Insurers Leaving the Marketplace in 2027: What It Means for You

Why insurers are leaving for 2027

Insurers leave a state's individual market for business reasons: losses, a smaller pool of buyers or a company-wide decision to exit. 2027 has more of those decisions than most years. Rates are up, the enhanced tax credits ended after 2025, and fewer healthy people are buying their own coverage.

Nationally, KFF counted 11 insurers that had announced an exit from at least one state's Marketplace for 2027, against seven that announced they would enter a new state. One national insurer is leaving the individual market in all 11 states where it sold plans.

Exits in my states

Across the 31 states where I am licensed, state rate filings show 14 insurer exits in 10 states:

• Arkansas: two insurers leaving, four remain.
• Delaware: one of the state's three individual-market insurers is leaving.
• Indiana: two leaving, three remain.
• Iowa: one leaving, five remain.
• Kansas: five insurers selling plans, one leaving.
• Kentucky: one insurer leaving kynect, the state's exchange, where choices were already limited.
• North Carolina: one leaving, five continue.
• Oklahoma: two leaving, five continue.
• Tennessee: six insurers filed, one leaving.
• Texas: about 15 insurers filed, two leaving.

The count adds exits state by state, so one company leaving three states counts three times. I am not naming companies here. Your notice will tell you if your insurer is leaving, and HealthCare.gov or your state exchange shows which insurers sell in your county.

Some states show no exits at all. Wisconsin has 12 insurers filing and none leaving, and Nebraska has five with none leaving.

The notice you should receive

When an insurer leaves a state's individual market entirely, federal rules generally require at least 180 days' written notice. When an insurer drops one plan but stays in the market, the notice period is generally 90 days. Look for words like "discontinued," "nonrenewal" or "we are leaving your area."

Your plan still works through December 31, 2026. Keep seeing your doctors and filling prescriptions. The notice does not end your coverage early.

Automatic re-enrollment, also called a crosswalk

If you do nothing, the Marketplace tries to prevent a gap. On HealthCare.gov, people whose plan is ending may be automatically re-enrolled in a plan for 2027. When the insurer is leaving altogether, that replacement can come from a different insurer. This mapping from old plan to new plan is often called a crosswalk.

The crosswalk is a safety net, not a recommendation. The replacement is chosen by rules, not by looking at your doctors or prescriptions. It can differ from your 2026 plan in:

• Network. Your doctors, hospital or pharmacy may be out of network.
• Drug list. A medication can move to a higher tier or drop off.
• Deductible and out-of-pocket maximum. For 2027 the ACA cap is $12,000 for one person and $24,000 for a family.
• Price. Rates in my states are up about 16 percent on average for 2027, and your tax credit may change too.

States with their own exchanges, like Kentucky's kynect, run their own re-enrollment process. Check your exchange's notice to see how it handles your plan.

Your special enrollment period

Losing coverage because your plan is discontinued is a qualifying event. It generally opens a special enrollment period from 60 days before to 60 days after the coverage ends. For a plan ending December 31, that window overlaps with open enrollment.

In practice, the deadline that matters is December 15, 2026. Pick a plan by then on HealthCare.gov and it starts January 1 with no gap. Open enrollment runs through January 15, 2027, but a plan chosen after December 15 generally starts February 1. The special enrollment period helps if you miss open enrollment entirely. It is not a reason to wait.

What to do this month

1. Find your notice and confirm whether your plan or your whole insurer is leaving.
2. Log in to HealthCare.gov or your state exchange and see which plan you are being moved to.
3. List your doctors, hospital and prescriptions, and check each one against the replacement plan and two or three alternatives.
4. Update your 2027 income estimate. The credit for 2027 stops at 400 percent of the federal poverty level, $63,840 for one person and $86,560 for two.
5. Choose actively by December 15. Even if the crosswalk plan is fine, choosing it yourself means you checked it.
6. Price a private plan if you are healthy and above the subsidy line. More on that below.

When a private plan is worth a look

An insurer exit forces a decision anyway, so it is a good time to compare more than one kind of plan. Private, medically underwritten plans are priced on age, ZIP code and health, not income. You answer health questions, and approval depends on those answers. If approved, a private plan can start on the first of the month you choose, so you can line it up with January 1.

Because approval is not certain, apply in November or the first days of December. If you are approved, set the start date for January 1. If you are not, you still have until December 15 to pick a Marketplace plan. My guide on switching from the Marketplace to a private plan covers the steps.

Private plans are not ACA Marketplace plans. Benefits and pre-existing condition rules vary by plan, so read the plan documents. If you have an ongoing health condition, a Marketplace plan is usually the safer choice.

Fewer insurers can mean higher prices

When an insurer leaves, the remaining ones take on its members. That can push rates up. In Arkansas, the final 2027 average rose a little as the exiting insurers' enrollees moved to the four that remain. Fewer insurers can also mean less price competition in later years. In rural counties in states like Oklahoma and Kentucky, buyers may be down to two or three choices.

An exit can also move your tax credit. The credit is tied to a benchmark silver plan in your area. If the insurer that offered the benchmark plan leaves, a different plan becomes the benchmark, and your credit changes with it. That is one more reason to look at your actual 2027 numbers instead of assuming they match 2026.

Exits do not line up neatly with price increases, though. Iowa and Arkansas both lost insurers and still have the smallest 2027 increases in my states, while Oklahoma lost two and is up more than 21 percent.

If you are in the middle of treatment

An insurer exit is hardest on people who are in the middle of treatment. A few steps help:

• Refill prescriptions in December while your current plan still pays, as far as your plan allows.
• Ask your specialists which 2027 plans they will accept before you pick one. Their offices often know which networks they are joining or leaving.
• Talk to your doctor about timing for care that is already approved under your current plan.
• Ask about prior authorizations. An approval from your old insurer does not carry over to a new one, so your doctor's office may need to request it again under the new plan.

Deductibles and out-of-pocket totals start over on January 1 in almost every individual plan anyway, so switching insurers usually does not cost you deductible progress for the new year.

Leaving the exchange or leaving the market

Ask one more question when you read your notice: is the insurer leaving the whole individual market in your state, or only the Marketplace? Some insurers stop selling through the exchange but keep a few off-exchange plans. Off-exchange plans cannot receive the premium tax credit, so for most people with a credit the practical answer is the same. You need a new Marketplace plan.

If your insurer is not leaving

Even with no exit, your plan may change. Insurers redesign their plan lineups every year. Read your renewal notice, compare at least three plans and see my discontinued plan guide if your specific plan is ending.

Let me check your replacement plan

Send me your notice or tell me your current plan, your ZIP code and your doctors. I will check the crosswalk plan and the alternatives, and price a private plan if it makes sense. There is no fee for my help. Get a quote or call (786) 218-2384. I am based in Tampa, Florida, and work with clients by phone and video across my states, including Indiana and Oklahoma.