ACA Insurers Exit, Prices Spike

Eleven insurance companies have announced they will withdraw from the Affordable Care Act marketplace. This exodus comes as the remaining providers increase premiums by up to 15 percent. It marks the second year in a row that the marketplace has seen a double-digit price hike.

The changes stem from Congress's decision not to renew pandemic-era subsidies. When those subsidies expired last year, prices rose sharply. Many consumers could not afford to renew their previous plans. Those who secured coverage opted for cheaper, lower-quality tiers. However, even these bronze-level plans cost more than what members paid in prior years.

The combination of higher costs and thinner coverage has reduced profitability for insurers. Cigna is among the carriers exiting the market. A spokesperson for the company pointed to remarks made by CEO Brian Evanko in April. Evanko stated that leaving 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 shift in market dynamics. “The main takeaway is that more insurance companies are leaving the marketplace than coming in,” Cox said. The reduction in available plans limits consumer choice during the annual enrollment period.

Open enrollment for ACA insurance began on Saturday, November 1. Early reports indicate technical difficulties on the federal website. Users reported waiting up to 30 minutes to receive security codes. Once logged in, applicants found far fewer plan options than in previous years.

Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh, warned of potential disruptions to care. “This is going to create a lot of discontinuities in care and coverage for people,” Yaver said. She explained that if a doctor does not accept the limited options available, it can be very disruptive, especially for individuals with chronic illnesses.

Yaver added that if the remaining price points do not fit a consumer's budget, the question of continued coverage arises. One enrollee currently pays about $185 per month for a bronze plan. That same plan will cost $322 per month next year. The individual stated they likely will not be able to afford the increase even while working two jobs.