Centene announced additions of 55 counties for the 2027 Affordable Care Act exchanges while also withdrawing from two states. The company said it will stop offering Marketplace plans in Delaware and New Hampshire next year. Investigators reported that because of those state exits, the 55-county expansion does not represent a net expansion of Centene’s geographic footprint for 2027. A Centene spokesperson did not provide county-level details in response to requests included in the source article.
The insurer said its Ambetter subsidiary will add condition-specific plan options for people with congestive heart failure, diabetes and asthma. The company plans to keep offering virtual care and member incentives such as rewards programs and retail and fitness discounts, the press release indicated.
Oscar Health is adding roughly 140 new counties for 2027, including entering South Carolina for the first time, the company reported. Oscar currently covers about 2.9 million ACA enrollees and told investors it expects to add between 400 and 600 new counties by 2029. The company attributed that expansion to strong financial performance earlier in the year, according to investor materials cited in the source.
The carrier is also expanding product offerings: a plan to help early retirees transition from the ACA into Medicare, menopause-focused products for women, concierge services and supermarket discounts at Hy-Vee were all mentioned in Oscar’s release.
UnitedHealthcare said it will stop offering ACA plans in Georgia next year. Despite that state exit, the insurer’s overall footprint — about 1,300 counties — remains similar to 2026, indicating the company added counties elsewhere to offset Georgia’s removal. A UnitedHealth spokesperson confirmed county additions in some states and emphasized that the company evaluates exchanges on a state-by-state basis each year, the article reported.
The article situates these carrier moves against a tightened ACA market. More generous premium subsidies for ACA coverage expired at the end of 2025, and the KFF data cited in the story showed ACA enrollment fell by more than 4.6 million people as of June. The enrollment decline was described in the source as steeper than many expected and concentrated among healthier people leaving coverage, which the article said contributes to a sicker, smaller risk pool and higher expected insurer spending.
The reporting also noted Trump administration actions intended to reduce fraud — including efforts that resulted in legitimate enrollees losing coverage, per the source — as an added element of uncertainty for carriers operating in the exchanges.
Multiple major insurers told the market they will exit some or all ACA marketplaces for 2027. The source listed firms including Cigna Healthcare, Baylor Scott & White, CareSource, Providence Health Plan and Molina among those planning departures that will affect hundreds of thousands of enrollees across several states.
Insurers remaining in the exchanges have proposed significant premium increases for 2027. The article referenced a proposed median rate increase of 15% for next year, a figure reported by the HealthSystem Tracker and framed by the Commonwealth Fund as the largest back-to-back premium rise since 2018. These requests come amid an environment of shrinking enrollment and a risk pool that the source characterized as smaller and potentially sicker.
Both Centene and Oscar are reshaping product portfolios in response to market pressures. Centene’s Ambetter will promote condition-specific plans and digital and retail partnerships. Oscar is targeting niche groups — early retirees and women in menopause — and expanding membership perks including concierge care and supermarket discounts. The source reported these moves as strategic attempts to attract more stable, higher-value enrollees and to control medical spending.
Two other major carriers, Health Care Service Corporation and GuideWell, reported no footprint changes for 2027. Elevance and Kaiser Permanente did not respond to the article’s requests for comment, the source stated.
The source article documents several open items. Centene did not supply county-level detail in response to outreach. Elevance and Kaiser Permanente did not reply to requests for information. UnitedHealth offered a general statement from Eric Hausman that the company will continue to evaluate exchanges annually.
Open enrollment for 2027 ACA plans begins Nov. 1 in most states, the article reported. The piece ends on concrete market uncertainties documented in the reporting: how carrier exits will affect enrollees, whether proposed rate increases will be approved as filed, and which additional counties insurers will add or drop as they finalize filings ahead of open enrollment.