ACA marketplace changes in 2026 are raising new questions for individuals and families about what’s happening and what alternatives to traditional insurance exist. Recent developments, including Cigna’s decision to exit the ACA marketplace in select states, have added to growing uncertainty around healthcare options.
Cigna Says No
For residents in Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas, and Virginia, the ACA marketplace is losing yet another major provider.
Cigna has announced it will exit ACA marketplace participation in these states ahead of the next open enrollment period. The decision reflects a broader business shift, as the company redirects resources toward areas that it sees as aligned with its ideas on cost and revenue.
This exit represents more than just a reduction in carrier participation. It also tightens an already limited marketplace, reducing the number of available plan options for consumers in affected states. When fewer insurers participate in a market, competition among plans themselves naturally decreases. Over time, this can lead to fewer plan choices and less pressure on remaining carriers to differentiate on pricing or benefits in the same way a more competitive market might. The result is higher cost and reduced service.
This marks the second major carrier exit from subsets of the ACA marketplace recently, underscoring a broader pattern across the industry.
ACA Marketplace Plans Are Changing and Consolidating: What It Means for You
Recent developments in the ACA marketplace continue to reflect ongoing change in healthcare coverage.
ACA marketplace plans are not just changing, they are consolidating into fewer and fewer options. Much like the cable companies of a few decades ago, as competition erodes into one or two providers, so do the available offerings and overall value.
While a majority of Americans have consistently rejected single-payer proposals over the past several administrations, many current ACA offerings can feel like single-payer options by default. However, without the guardrails of a regulated single-payer system, the benefits and structure tend to favor large health care organizations more than the average middle-class American.
In recent years, these shifts have included:
- Carriers adjusting or exiting ACA marketplace participation in certain states
- Changes to available ACA plan options during open enrollment
- Shifts in provider networks tied to marketplace plans
- Plans not being renewed or replaced at renewal
- Premiums increasing at rates that outpace inflation, while policies work to erode provider pay
These changes can impact access to care, provider continuity, and overall plan stability.
For many Americans, this can mean:
- Changes in available doctors or provider networks
- Adjustments in plan options from year to year
- Uncertainty about whether current coverage will continue at renewal
For many, these changes can create frustration, uncertainty, and the need to repeatedly reevaluate healthcare decisions each year.
Exploring Alternatives to ACA Marketplace Plans
As these challenges continue to evolve, many individuals and families are looking for a different approach that feels more predictable and easier to navigate.
Health Care Sharing Ministries (HCSMs) offer a community-based approach where members contribute to help share eligible medical expenses. This provides a different way to navigate healthcare needs during a time of ongoing change. Instead of navigating complex insurance structures and administrative layers, members participate in a more direct, community-driven model focused on shared responsibility and support.
How netWell™ Brings Calm To The Chaos of a Changing Healthcare System
netWell™ is a nonprofit HCSM designed to provide a flexible, community-based approach to managing healthcare needs.
With Always-Open Enrollment, members are not limited by ACA enrollment windows or qualifying life events, allowing them to join at any time.
netWell also provides access to a nationwide provider network through Aetna’s First Health® PPO, which may allow many members to continue seeing their preferred doctors and specialists.
Members also benefit from additional resources designed to support their healthcare needs, including:
- Nationwide lab services through Labcorp
- Prescription savings through the revive® Prescription Benefit Program
- Expert hospital bill negotiation through Goodbill
- Discounted dental options through netWell™ Dental
- Discounted 24/7 veterinary support powered by whiskerDocs for members with pets
Unlike traditional insurance models that can feel heavily structured and influenced by administrative layers, netWell is designed to reduce unnecessary complexity and focus more directly on members and their healthcare needs.
The goal is to support a system where healthcare decisions are guided by care and community, not by corporate profit.
Frequently Asked Questions About Health Care Sharing
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- What is health care sharing?
Health care sharing is a membership-based approach where individuals share eligible medical expenses within a community rather than using traditional health insurance. - How is health care sharing different from ACA marketplace plans?
Unlike ACA marketplace plans, health care sharing is not insurance. It is a community-based model where members share eligible medical costs rather than navigating traditional insurance structures and carrier networks. - Can I still see my doctor when I switch to a HCSM?
Though every program is different, netWell members have access to providers through Aetna’s First Health® PPO network, which includes doctors and specialists nationwide, allowing many members to keep their provider when they make the switch. Even if your favorite provider is not a member of the national First Health PPO network, there are still ways to continue to see the same licensed provider. Ask one of our HCSM Advisors how this works.
- What is health care sharing?
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- Is enrollment limited to certain times of the year?
No. netWell offers Always-Open Enrollment, allowing individuals to join at any time without waiting for an ACA enrollment period or a qualifying life event. - What types of healthcare needs are supported?
Health care sharing programs like netWell can facilitate sharing for eligible medical expenses such as hospital visits, surgeries, urgent care, and even telehealth appointments based on membership guidelines.
- Is enrollment limited to certain times of the year?
Learn More
If recent ACA marketplace changes have left you exploring your options, netWell offers a flexible alternative designed to support your healthcare needs.
