---
title: "Centene, Oscar, UnitedHealthcare adjust county footprints for 2027 ACA plans"
id: "healthcare-dive-1-centene-oscar-unitedhealthcare-sidle-into-some-new-counties-in-2027-aca-plans"
canonical_url: "https://medichelpline.com/clinical-feed/healthcare-dive-1-centene-oscar-unitedhealthcare-sidle-into-some-new-counties-in-2027-aca-plans"
content_type: "clinical_feed_article"
specialty: "General"
source_name: "Healthcare Dive"
source_url: "https://www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/"
published_at: "2026-10-21T13:09:58.000Z"
evidence_level: "Verified Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Centene, Oscar, UnitedHealthcare adjust county footprints for 2027 ACA plans
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/healthcare-dive-1-centene-oscar-unitedhealthcare-sidle-into-some-new-counties-in-2027-aca-plans
- **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md)
- **Primary Source:** Healthcare Dive
- **Source URL:** [Original Journal Publication](https://www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/)
- **Published At:** 2026-10-21T13:09:58.000Z
- **Evidence Rating:** Verified Feed
## Executive GIST (TL;DR)
- Centene is adding 55 counties for 2027 while exiting Delaware and New Hampshire; the net geographic footprint for 2027 is unchanged, investigators reported. - Oscar Health is entering roughly 140 new counties for 2027, including a first-time entry into **South Carolina**, and plans to add 400–600 counties by 2029, the company said during investor communications. - UnitedHealthcare will stop offering ACA plans in **Georgia** next year, but its overall footprint of about 1,300 counties remains similar, indicating offsetting county additions in other states, a spokesperson confirmed. - The moves were disclosed in company press releases and investor statements; spokespeople for Centene did not provide county-level details in the source report. - The report ties these footprint adjustments to a broader market reaction after more generous ACA subsidies expired at the end of 2025 and enrollment fell by more than 4.6 million through June, according to KFF data cited by the story. - Several major carriers (Cigna Healthcare, Molina, CareSource, Baylor Scott & White, Providence Health Plan and others) plan to exit some or all ACA marketplaces for 2027, affecting hundreds of thousands of enrollees, the article noted. - Insurers are requesting substantial rate increases for 2027; the source cites a proposed median increase of 15% and says it would be the largest back-to-back premium rise since 2018, per the Commonwealth Fund. - Companies are also rolling out targeted plan designs: Centene’s Ambetter will offer condition-specific plans for congestive heart failure, diabetes and asthma; Oscar is offering plans for early retirees and menopause-focused products, plus concierge and retail discounts. - Open enrollment for 2027 ACA plans begins Nov. 1 in most states; the article also reports some carriers (Elevance, Kaiser) did not respond to requests for comment and that UnitedHealth’s Eric Hausman said the company evaluates exchanges annually.
## Clinical Analysis & Structured Key Points
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Published Oct. 21, 2026 [ ![Rebecca Pifer Parduhn's headshot](https://d1b6lhn2ymmy1x.cloudfront.net/journalist-headshots/healthcare/pifer-rebecca-circle-150x150.png) ](https://www.healthcaredive.com/editors/rparduhn/) [Rebecca Pifer Parduhn](https://www.healthcaredive.com/editors/rparduhn/) Senior Reporter * [ ![](https://www.healthcaredive.com/static/img/social_icons/share-icon.svg?151116201026) Share ](javascript:void\(0\)) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/share-link-box.svg?151116201026) Copy link ](javascript:void\(0\)) * ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/email.svg?151116201026) Email * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/linkedin.svg?151116201026) LinkedIn ](https://www.linkedin.com/shareArticle?mini=true&url=https%3A//www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/&title=Centene%2C%20Oscar%2C%20UnitedHealthcare%20sidle%20into%20some%20new%20counties%20in%202027%20ACA%20plans) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/x.svg?151116201026) X/Twitter ](https://twitter.com/intent/tweet?text=Centene%2C%20Oscar%2C%20UnitedHealthcare%20sidle%20into%20some%20new%20counties%20in%202027%20ACA%20plans%20https%3A//www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/%20via%20@healthcaredive) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/facebook.svg?151116201026) Facebook ](https://www.facebook.com/sharer/sharer.php?u=https%3A//www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/print.svg?151116201026) Print ](javascript:window.print\(\)) * [ ![](https://www.healthcaredive.com/static/img/social_icons/article_page/license-icon.svg?151116201026) License ](https://www.healthcaredive.com/selfservice/article-licensing/submit/?newspostUrl=https://www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/) * [ ![](https://www.healthcaredive.com/static/img/social_icons/article_page/bookmark-add.svg?151116201026) Add us on Google ](https://www.google.com/preferences/source?q=https://www.healthcaredive.com) ![A sign reading OBAMACARE hangs outside a storefront.](https://imgproxy.divecdn.com/JU16ptUEmOgZJbAugKcX7wNOmyyhfaBm6yCAMwOCPAQ/g:ce/rs:fill:1200:675:1/Z3M6Ly9kaXZlc2l0ZS1zdG9yYWdlL2RpdmVpbWFnZS9HZXR0eUltYWdlcy0xMjk5MTU3NTQ1LmpwZw==.webp) A pedestrian walks past the Leading Insurance Agency, which offers plans under the Affordable Care Act, on Jan. 28, 2021, in Miami. Joe Raedle via Getty Images ![](https://www.healthcaredive.com/static/img/play.svg?151116201026) Listen to the article 5 min This audio is auto-generated. Please let us know if you have [feedback](https://www.healthcaredive.com/contact/). Some major insurers in the Affordable Care Act exchanges are expanding into new counties for 2027, even as many of their peers run for the exit amid ongoing cost and policy turbulence. Centene, the largest ACA insurer in the U.S., is expanding [into 55 additional counties in Alabama, Iowa, Illinois, Louisiana, Michigan, New Jersey and Texas](https://investors.centene.com/2026-10-20-Ambetter-Health-Announces-2027-Marketplace-Offerings,-Including-Enhanced-Condition-Specific-Coverage-Options) next year; while Oscar Health, one of the fastest-growing carriers in the exchanges, is [adding 140 new counties](https://www.businesswire.com/news/home/20261020140529/en/Oscar-Introduces-a-New-Wave-of-Consumer-Health-Products), including by entering South Carolina for the first time. The changes, announced in press releases Tuesday, show a continued bet on the ACA among some major participants in the exchanges, which may see a growth opportunity as their competitors downsize and leave their members looking for new carriers. Oscar, which covers about 2.9 million ACA enrollees, is currently in the middle of a major multi-year expansion in the ACA exchanges. The company plans to add between 400 and 600 new counties by 2029, [fueled by record profits](https://ir.oscarhealth.com/news-events/press-releases/detail/224/oscar-health-announces-record-financial-results-for-first-half-2026-and-raises-full-year-2026-outlook) in the first half of this year, executives said [during an investor day](https://oscarhealth.com/news/oscar-health-building-new-consumer-health-economy) last month. In Centene’s case, the county additions paper over the company’s decision to exit two states next year as it refocuses on more profitable markets. Centene, which covers more than 3.5 million people on the ACA exchanges, is no longer offering Marketplace plans [in Delaware](https://www.ambetterhealth.com/en/de/provider-resources/provider-news/discontinue-marketplace-coverage-effective-december-31-2026/) or [New Hampshire](https://www.ambetterhealth.com/en/nh/provider-resources/provider-news/discontinue-marketplace-coverage-nh-2027-plan-year/) next year. Accordingly, the 55 new counties it’s adding for 2027 don’t represent a net change to Centene’s geographic footprint for 2027. A spokesperson did not respond to a request for county-level details. Similarly, UnitedHealthcare, the largest private insurer in the U.S. with a significant presence in the ACA, is shutting down its ACA plans in Georgia next year — but the company’s footprint of about 1,300 counties is unchanged, suggesting it’s expanding in its remaining 29 states. A spokesperson confirmed that UnitedHealthcare has added counties in some states, so the total is similar. “We will continue to carefully evaluate exchanges on a state-by-state basis each year to assess future opportunities as this market matures and develops,” Eric Hausman, UnitedHealth’s vice president of media relations, said. Keep up with the story. Subscribe to the Healthcare Dive free daily newsletter Email: * Select Newsletter: Daily Dive M-F * Select Newsletter: Payer Weekly Every Wednesday * Select Newsletter: IT Weekly Every Thursday * Select user consent: By signing up to receive our newsletter, you agree to our [Terms of Use](https://www.informatechtarget.com/terms-of-use/) and [Privacy Policy](https://www.informatechtarget.com/privacy-policy/). You can unsubscribe at anytime. Sign up A valid email address is required. Please select at least one newsletter. Two other major ACA insurers — Health Care Service Corporation, which offers marketplace coverage in five states, and GuideWell, a major Florida operator with plans in each of the state’s 67 counties — made no changes to their footprints for 2027, according to spokespeople for both companies. Elevance and Kaiser Permanente did not respond to a request for information on their 2027 plans. Insurers are repositioning after a difficult year in the exchanges. [More generous subsidies for ACA coverage expired](https://www.healthcaredive.com/news/enhanced-aca-subsidies-expire-congress/808418/) at the end of 2025, sending enrollment plummeting. As of June, [ACA enrollment had fallen](https://www.kff.org/affordable-care-act/individual-market-enrollment-continues-to-fall-through-mid-2026/) by more than 4.6 million people, according to the KFF — a steeper decline than most market watchers expected, as Americans, facing sky-high monthly costs for coverage, dropped out of the exchanges in droves as the year progressed. That’s resulted in a smaller and apparently sicker risk pool, given healthier people are more likely to drop coverage, which is expected to raise spending for insurers. At the same time, [Trump administration policies](https://www.healthcaredive.com/news/trump-administration-boots-189000-deceased-duplicate-enrollees-off-aca-su/833037/) [aimed at reducing fraud](https://www.healthcaredive.com/news/cms-freezes-new-aca-broker-registrations-for-2027/831138/) in the exchanges have caused legitimate enrollees to lose coverage and created additional uncertainty in the markets. Many insurers are deciding it’s just not worth the hassle: Roughly a dozen carriers have said [they plan to exit the ACA marketplaces](https://www.kff.org/affordable-care-act/tracking-insurer-participation-changes-in-the-aca-marketplaces-in-2027/) after this year, in some or all states they operate. The exits, among Cigna Healthcare, Baylor Scott & White, CareSource, Providence Health Plan, Molina and others, are set to affect hundreds of thousands of enrollees across multiple states. Those remaining are asking for double-digit rate increases for the second year in a row, proposing a median [15% rate increase](https://www.healthsystemtracker.org/brief/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2027) for 2027. It’s the highest [back-to-back rate increase in the marketplace since 2018](https://www.commonwealthfund.org/blog/2026/more-aca-premium-spikes-come-2027-amid-federal-policy-changes), according to the Commonwealth Fund. Insurers are also reshaping their plans, including by making them more personalized — betting that plans targeted at individuals’ specific needs, including chronic disease management, will attract more members and help control medical spending. Centene, which offers ACA coverage through its Ambetter subsidiary, is rolling out condition-specific plans, including for congestive heart failure, diabetes and asthma, that are deeply popular with members, the insurer said in its Tuesday release. Centene will also continue offering round-the-clock virtual care, rewards programs for members completing health activities and discounts at partners including Walgreens and the YMCA. Meanwhile, Oscar is introducing a plan aimed at helping early retirees transition from ACA coverage into Medicare, the company said. Oscar is also expanding plans targeted at women going through menopause, along with concierge care and discounts at Hy-Vee supermarket stores. Open enrollment for 2027 ACA plans begins Nov. 1 in most states. ### Recommended Reading * [ ‘Back on track’: Centene swings to more than $1B in profit in Q2 ](https://www.healthcaredive.com/news/centene-cnc-q2-2026-guidance-hike-aca-medicaid/826286/) By [Rebecca Pifer Parduhn](https://www.healthcaredive.com/editors/rparduhn/) • July 28, 2026 * [ ACA enrollment declines by nearly 3M ](https://www.healthcaredive.com/news/affordable-care-act-enrollment-declines-3-million-hhs/823975/) By Emily Olsen • June 29, 2026 * [ CMS freezes new ACA broker registrations for 2027, culls ‘unauthorized’ enrollees ](https://www.healthcaredive.com/news/cms-freezes-new-aca-broker-registrations-for-2027/831138/) By [Jill Hughes](https://www.healthcaredive.com/users/jillhughes/) • Sept. 23, 2026 * [ ![](https://www.healthcaredive.com/static/img/social_icons/article_page/bookmark-add.svg?151116201026) Add us on Google ](https://www.google.com/preferences/source?q=https://www.healthcaredive.com) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share-icon.svg?151116201026) Share ](javascript:void\(0\)) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/share-link-box.svg?151116201026) Copy link ](javascript:void\(0\)) * ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/email.svg?151116201026) Email * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/linkedin.svg?151116201026) LinkedIn ](https://www.linkedin.com/shareArticle?mini=true&url=https%3A//www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/&title=Centene%2C%20Oscar%2C%20UnitedHealthcare%20sidle%20into%20some%20new%20counties%20in%202027%20ACA%20plans) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/x.svg?151116201026) X/Twitter ](https://twitter.com/intent/tweet?text=Centene%2C%20Oscar%2C%20UnitedHealthcare%20sidle%20into%20some%20new%20counties%20in%202027%20ACA%20plans%20https%3A//www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/%20via%20@healthcaredive) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/facebook.svg?151116201026) Facebook ](https://www.facebook.com/sharer/sharer.php?u=https%3A//www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/) * [ ![](https://www.healthcaredive.com/static/img/social_icons/share_dropdown/print.svg?151116201026) Print ](javascript:window.print\(\)) * [ ![](https://www.healthcaredive.com/static/img/social_icons/article_page/cart.svg?151116201026) License ](https://www.healthcaredive.com/selfservice/article-licensing/submit/?newspostUrl=https://www.healthcaredive.com/news/centene-oscar-unitedhealthcare-new-counties-aca-2027/833442/) Filed Under: [Payer](https://www.healthcaredive.com/topic/payers/) ### Healthcare Dive news delivered to your inbox Get the free daily newsletter read by industry experts Email: * Select Newsletter: Daily Dive M-F * Select Newsletter: Payer Weekly Every Wednesday * Select Newsletter: IT Weekly Every Thursday * Select user consent: By signing up to receive our newsletter, you agree to our [Terms of Use](https://www.informatechtarget.com/terms-of-use/) and [Privacy Policy](https://www.informatechtarget.com/privacy-policy/). 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By Emily Olsen • May 22, 2025 * [ ![Sen. Chuck Grassley gestures as he speaks during a committee meeting.](https://imgproxy.divecdn.com/2Pj8ZQVVd_4Z673c7zfvppCoZ-qg8MRdGmdsLriv97Q/g:nowe:0:113/c:790:446/rs:fill:1200:675:1/Z3M6Ly9kaXZlc2l0ZS1zdG9yYWdlL2RpdmVpbWFnZS9HZXR0eUltYWdlcy0yMTk5NDI3NjE2LmpwZw==.webp) ](https://www.healthcaredive.com/news/senate-judiciary-backs-pbm-reform-hearing/747989/) ![Image attribution tooltip](https://www.healthcaredive.com/static/images/info-icon.png?151116201026) Anna Moneymaker via Getty Images ![Image attribution tooltip](https://www.healthcaredive.com/static/images/info-icon.png?151116201026) ### [ Stopping a ‘moral obscenity’: Senate Judiciary Committee expresses support for PBM reform ](https://www.healthcaredive.com/news/senate-judiciary-backs-pbm-reform-hearing/747989/) Sen. 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