Attention ACA health insurance agents! Aetna announcing on May 1 that it’s leaving the ACA market next year. What does this mean for insurance agents serving the one million Aetna ACA customers, and what does this tell us about the 2026 insurance market overall?
If you currently partner with Aetna on ACA, you should do the following:
- Contact your Aetna ACA clients and tell them:
- Nothing is changing for them now; they have coverage through the end of 2025.
- You’ll help them find a new ACA solution that best meets their needs during the upcoming ACA Annual Enrollment Period.
- You’ll send information that the client needs to complete and send back to you about their current circumstances, so you know exactly what insurance options they need.
- You’ll send them regular insurance news updates and information they need to know heading into 2026.
- Start finding new ACA partners in your Aetna markets that come close to, or surpass, Aetna’s 2025 product portfolio.
- Stay informed about what your carrier partners say and do in 2025, as this is a window into what they can do for 2026 policy benefits.
What Does This Tell Us About the 2026 Insurance Market?
If Aetna leaving ACA was the only story out there, you can see it as Aetna specifically addressing an issue within its corporate structure. However, Elevance is now only accepting paper applications for its 2025 Medicare Advantage Plans, and no more enrollments are occurring through the online Medicare Advantage broker portal. UnitedHealthcare, the largest payor in the nation, announced disappointing 2025 first-quarter earnings due to much higher-than-expected Medicare Advantage costs.
All these events combine to paint a picture of payors under significant cost pressures in 2025, and they must address these cost pressures in 2026 operations. Each payer has unique business circumstances to address, either negative or positive.
We shouldn’t be surprised, however, to see more payors “adjusting” their ACA, Medicare, and commercial markets either in geographic size or by continuing to do business in a market. Stay tuned for more updates like this as soon as we receive them about what payors are doing or what we see them announce in their financial statements about their plans for the rest of 2025 heading into 2026.
Pandora Insurance is here to help you navigate these choppy waters and safely reach the other side for you and your agency clients.
Contact us today if you have any further questions at 305-603-7603.
This information is confidential and intended solely for broker use.
