Imagine that next year, you go to your health insurance website on the internet and find out that your provider will not be available. Aetna’s parent company, CVS Health, has pledged that Aetna will not be in the ACA marketplace, and this will now be the new normal for nearly a million Americans.
This ruling affects 17 states where Aetna has provided insurance under the ACA. The withdrawal of Aetna’s ACA plans may come as millions depend of their ACA insurance for needed health care, and those without access to insurance will be left wondering what insurance coverage will mean for pricing or access, for if CVS is promising that other coverage options will still exist.
What Sparked the Exit?
The imminent end of the government-based subsidies created by the Biden administration in 2021 is a significant reason for the Aetna ACA withdrawal. Aside from generating record enrollment—about 24 million people this year, not including his numbers according to Forbes—these incentives enabled many folks in America to cut down on their rates. Still, at CVS’s expense, Aetna does not believe it is feasible for Aetna to participate in the ACA marketplace when it ceases to operate the financial aid in 2026.
Even though Aetna may not be the largest player in the ACA ecosystem, Aetna’s exit causes reverberations. When implying Aetna would shift itself to other – instead of government-backed – plans on the ACA exchange, CVS stated, “The Company is better positioned to serve members through its other health benefits solutions.”
Not the First Time, But the Stakes Are Higher Now
Aetna has a history of exiting the ACA marketplace. In 2017 and 2018, it exited the marketplace and then re-entered in 2021, but the stakes are arguably much greater now. With rising health care costs and inflation continuing to impact individuals’ and families’ finances, many Americans are counting on subsidized ACA plans for their health care coverage.
For families with incomes just above the cutoff for Medicaid, the Aetna ACA withdrawal could mean the difference between having insurance or no insurance. When it comes to reasonable health care options, especially for the middle class that doesn’t qualify for government assistance, the options are pretty scarce.
What Happens Next?
As reported by CVS, Aetna will manage transition-related activities in 2026 and will maintain existing ACA members through 2025. However, some in the industry are warning to be prepared for some potential disruptions. According to one health care analyst, “if the premiums increase or they don’t find comparable plans, we might see people drop their insurance altogether.”
But and for the sake of not creating a larger coverage issue, the health care organizations are calling for continued ACA tax credits. If there is inaction at the lawmaker level, millions may see increased costs with insurance, or worse, receive no coverage at all.
The Bigger Picture
The Aetna ACA withdrawal is as much an alert as it is a change in strategy. It serves as a reminder that corporate decisions and shifts in policy continue to shape access to health care in the U.S. Lawmakers are under more pressure to act as the 2026 deadline for subsidy expiration approaches. To avoid coverage gaps, consumers affected by the change are encouraged to review their options and do so quickly, and to reach out to health insurance navigators for help.
