Cigna is pulling out of the Affordable Care Act market next year, becoming the second major insurer to abandon the struggling exchange. The move adds to mounting turmoil in the ACA space, where rising premiums and the end of pandemic-era subsidies have triggered a rapid membership decline.

CVS Health's Aetna already exited at the start of this year, leaving fewer options for consumers. The exodus reflects broader challenges: ACA enrollment dropped from 24 million to 23 million for 2026, with steep attrition as people failed to keep up with premium payments after grace periods ended in March.

Rising monthly costs are driving policyholders away. Without the enhanced federal subsidies that boosted affordability during the pandemic, many families face significantly higher bills. Actuaries project enrollment could fall by a quarter this year as the market continues shrinking.

The insurance withdrawal signals deeper structural problems in the ACA marketplace. With fewer insurers competing, consumers may face even higher premiums and limited choices in 2026 and beyond.