Industry
Centene, UnitedHealthcare Expand ACA Counties Amid Broader Exits
Centene, Oscar, and UnitedHealthcare are adding new counties to their 2027 Affordable Care Act marketplace offerings even as a wave of insurers scales back exchange participation nationally. For Centene and UnitedHealthcare specifically, the new county additions mask larger overall state-level exits, meaning their net exchange footprint is shrinking despite the targeted expansions. The moves reflect insurers recalibrating ACA strategy amid shifting enrollment and risk dynamics heading into 2027. Consumers in dropped states and counties will need to find new marketplace plans during open enrollment.
Why it mattersFor Medicaid stakeholders, these ACA marketplace shifts matter because the same insurers managing exchange exits and entries often run Medicaid MCOs in overlapping markets, signaling broader shifts in their risk appetite and geographic strategy that could affect churn between Medicaid and marketplace coverage.