Aetna Drops Out of ACA Exchange In 2026—Here's How It Could Affect You

Forbes

6 days ago

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CVS Health, owner of Aetna, announced that Aetna will withdraw all Affordable Care Act (ACA) individual and family plans at the end of 2025. Coverage will continue through December 31, 2025, but starting January 1, 2026, Aetna-branded ACA plans will no longer be available.
Aetna cited persistent underperformance in the ACA exchange business, including substantial financial losses. CVS reserved about $448 million to cover anticipated losses in 2025, and leadership concluded there was no viable path to profitability in this market.
Roughly one million ACA enrollees across 17 states will need to find new coverage for 2026. The most impacted states include: Arizona
California
Delaware
Florida
Georgia
Illinois
Indiana
Kansas
Maryland
Missouri
Nevada
New Jersey
North Carolina
Ohio
Texas
Utah
Virginia
If you have an Aetna ACA plan right now, no need to worry—your coverage will stick around through the end of 2025. But when fall rolls around, it's smart to start exploring new options.
During Open Enrollment , expected to run from November 1, 2025, through mid-January 2026, you'll need to switch to a new insurer for 2026. This shift may be straightforward for some, but others may have to change doctors or hospitals if they aren't part of your new plan's network.
To help with this transition, you can expect outreach from health insurance brokers or messaging from the federal government. While Aetna covers just 4% of national ACA enrollees, its exit could have ripple effects in certain areas.
This isn't Aetna's first time pulling back from the ACA marketplace. After exiting in 2018 and coming back in 2022, the company is shifting gears once again.
Its parent company, CVS Health, is zeroing in on more profitable areas, such as pharmacy services and popular weight-loss drugs like Wegovy. That focus appears to be working: CVS reported nearly a 60% jump in first-quarter profits, pushing its stock price to new highs. Keep an eye out. Sometime around mid-2025, you'll get a letter or email saying it's time to pick a new plan. When open enrollment starts on November 1, 2025, visit HealthCare.gov or your state site to review your options and check if you qualify for discounts. If you're feeling overwhelmed, you can always ask an agent or broker to help navigate you through the process. Remember to make sure your usual doctors and hospitals are in-network, or you might have to switch providers.
Aetna's exit is prompting a recalibration of the ACA marketplace. Smaller, ACA-focused insurers such as Centene, which offers plans under the Ambetter brand, and Oscar Health prepare to absorb many of Aetna's displaced members.
At the same time, uncertainty around federal policy remains a concern. The enhanced subsidies that have kept premiums affordable are set to expire unless renewed. Without them, many enrollees could face higher costs, and insurers may become more selective in the risks they're willing to take on.
If you're losing your Aetna ACA plan, don't stress, as plenty of other options are available. Some of the best insurance companies , like Ambetter, Oscar Health and Molina Healthcare, are stepping up to cover folks in many states.
You might also qualify for Medicaid or the Children's Health Insurance Program (CHIP) , especially if your income has changed or you have kids. These programs usually don't cost much and can serve as a solid backup.
Short-term health plans are available, too, but they don't cover everything and usually exclude any preexisting health issues. Of course, it's always worth checking if you or someone in your family can get coverage through work. When Open Enrollment kicks off, take your time to review your options and choose the plan that best fits your needs.
Aetna will exit the ACA exchanges entirely after 2025, impacting around one million members across 17 states. Existing coverage remains through the end of 2025, and if the changes impact you, plan to shop for a new ACA plan during Open Enrollment in late 2025.