Open enrollment for 2027 Affordable Care Act (ACA) marketplace coverage begins November 1, 32 days away, and the market entering that window looks materially different from August. As of September 15, nine carriers have announced they will leave ACA marketplaces for plan year 2027, either in full or in selected states, according to KFF's insurer participation tracker. The count stood at six when prior coverage of 2027 ACA premium increases and the broker implications published on August 31.
The exits follow a year of enrollment decline after enhanced premium tax credits expired at the end of 2025. As healthier enrollees dropped coverage, the remaining risk pool grew older and sicker. Insurers have priced that deterioration into their 2027 rate filings.
The five exits with the largest combined enrollment are the most time-sensitive. Cigna is leaving all 11 of its marketplace states, affecting approximately 369,000 people. Baylor Scott and White Health Plan is exiting Texas, where it covers roughly 100,000 enrollees. CareSource is withdrawing from Indiana, Ohio, and West Virginia, while PacificSource is leaving Idaho, Montana and Oregon. ConnectiCare is terminating its Connecticut marketplace plans entirely. Combined, those five carriers cover well over 600,000 people who must select replacement coverage before December 15.
Clients whose plans terminate at the end of 2026 may be auto-assigned to a replacement carrier by their marketplace if they take no action before December 15. Auto-assignment defaults to the lowest-cost plan at the same metal tier, which may not preserve the client's network, formulary or provider relationships.
The replacement selection deadline is December 15 for a January 1, 2027 effective date. About 48% of adult individual market enrollees are employed by small businesses with fewer than 25 workers, are self-employed, or are small business owners, according to a 2025 KFF analysis.
Two consecutive years of double-digit individual market premium increases have been pulling that segment toward employer-sponsored coverage. The carrier exits accelerate the pressure on those clients to make a decision before enrollment opens. The increasing cost pressure on small employers facing the same renewal season adds further context to those conversations.
Several changes beyond the carrier exits affect how brokers should advise clients holding or considering individual market coverage.
Starting with 2027 coverage, marketplace subsidies will no longer be available to refugees, asylees, people with Temporary Protected Status, or holders of work or student visas, under H.R. 1, enacted July 4, 2025. Only lawful permanent residents, Cuban-Haitian Entrants and Compact of Free Association migrants retain subsidy eligibility.
In California alone, 112,600 marketplace enrollees - nearly 6% of the state's total - stand to lose their federal subsidies when the provision takes effect, according to data provided by Covered California to KFF Health News. Workers who lose eligibility face a choice between unsubsidized marketplace premiums and requesting employer group coverage they had not previously needed.
The individual out-of-pocket maximum rises to $12,000 for 2027, up from $10,600 in 2026. That change was not affected by the July federal court ruling that blocked several other administration rule provisions, and it takes effect as filed. For clients weighing individual market coverage against a small group plan, the wider out-of-pocket ceiling is a concrete variable the comparison should include.
On Catastrophic plans, a federal court stayed the administration's proposal to expand eligibility beyond the age-30 cutoff in July 2026. Catastrophic coverage remains available primarily to people under 30 and those meeting a hardship or affordability exemption. Clients who factored expanded Catastrophic access into their 2027 planning should verify their eligibility status.
Health savings account (HSA) contribution limits for 2027 rise to $4,500 for self-only coverage and $9,000 for family coverage, up from $4,400 and $8,750 respectively. Clients on high-deductible plans moving between coverage options can factor the higher ceiling into their total cost comparison.
