Aetna, the CVS Health-owned insurer, completed its exit from the ACA individual marketplace for plan year 2026, leaving members who held Aetna exchange coverage in Virginia and other states to find new plans during open enrollment — a reminder that marketplace participation is annual, not permanent, even for national carriers.
This article publishes information, not insurance advice. If your insurer announces a market exit, you qualify for loss-of-coverage special enrollment rights; a state marketplace navigator can confirm your dates.
What happened to Aetna's marketplace members?
CVS Health announced the pullback from the individual exchange business ahead of the 2026 plan year, and members had to select replacement coverage for January 1, 2026 during open enrollment, which ran November 1 through mid-January in most states, per the company's plan information and marketplace guidance from healthinsurance.org. Anyone who did not pick a new plan by the deadline risked a coverage gap, though losing a plan to an exit is itself a qualifying life event.
Related stories: Enhanced Subsidies Expired: 2026 Marketplace Enrollment Dropped by 1.2 Million · CMS-0057-F Kicked In January 1: Prior Authorization Records Go Electronic.
Why are insurers leaving marketplace counties?
Carriers cite two recurring reasons: medical cost trend that outpaced 2025-2026 premiums, and uncertainty from the expiration of enhanced premium tax credits on December 31, 2025, which made it harder to predict who would stay in the risk pool. Insurers that expected younger, healthier members to drop coverage priced for a sicker pool — one driver of the double-digit rate requests state reviewers saw for 2026, per Georgetown CHIR analysts.
What should former Aetna members check now?
Three things. First, confirm your new plan's network before your first appointment, because exits often push members onto narrower networks. Second, re-run the marketplace subsidy application if your income estimate changed — original premium tax credits still apply even though the enhanced version ended. Third, keep your termination notice: it documents the qualifying event if a special enrollment period ever comes into question.
What to watch next
Exit announcements for 2027 typically land in late spring, when insurers file rates with state departments. With enrollment down about 1.2 million nationally per CMS's January 2026 snapshot, analysts expect more counties to be down to a single marketplace insurer — and single-insurer counties historically see the sharpest premium increases.
For more context, read Enhanced Subsidies Expired: 2026 Marketplace Enrollment Dropped by 1.2 Million.
For more context, read unitedhealth q1 2026 results.
For more context, read unitedhealth q2 2026 earnings.