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Who sells Marketplace plans in 2026
| Insurer (brand) | States with Marketplace plans, 2026 | Notes |
|---|---|---|
| UnitedHealthcare | 30 | Expected to shrink Marketplace enrollment by about a third in 2026 |
| Centene (Ambetter) | 29 | Largest individual-market share (18% in 2024) |
| Oscar | 20 | Tech-focused insurer |
| Elevance (Anthem / Wellpoint) | 18 | Includes many Blue Cross Blue Shield plans |
| Molina | 14 | Focus on lower-income members |
| Cigna | 11 | Leaving the individual market after 2026 (about 369,000 people) |
| Kaiser Permanente | 10 | Integrated insurer and care system |
| Aetna (CVS) | 0 | Left after 2025 (about 1 million people in 17 states) |
Sources: KFF (June 2026); Becker’s Payer (May 2026).
KFF found an average of 9.0 insurers per state in 2026, down from a record 9.6 in 2025, and 165 counties with only one insurer. If your insurer is leaving, you’ll need to choose a new plan during open enrollment or you may be moved to a similar plan automatically.
Quality ratings: NCQA 2026
NCQA rates health plans from 0 to 5 based on clinical quality, patient experience and prevention. In 2026, 18 plans earned 5 stars, up from 11, and all were nonprofits; nine were Kaiser Permanente plans. Among publicly traded insurers, CVS/Aetna had the highest average (about 4 stars) and Cigna trailed. The average rating was about 3.5.
| 5-star commercial plans (2026) | Where |
|---|---|
| Blue Cross Blue Shield of Massachusetts | MA |
| Capital District Physicians’ Health Plan (CDPHP) | NY |
| Harvard Pilgrim Health Care | MA, ME |
| Independent Health | NY |
| Kaiser Permanente Mid-Atlantic States | DC, MD, VA |
| Kaiser Permanente Northern California | CA |
| UPMC Health Plan | PA |
Sources: Healthcare Dive and Becker’s Payer, September 2026. List shows selected 5-star commercial plans.
How to choose the best plan for you
- Start with your doctors. Use each insurer’s provider search to confirm your doctors and hospitals are in network for the specific plan, not just the insurer.
- Check your prescriptions on each plan’s drug list (formulary), including the tier and any prior authorization.
- Compare total yearly cost: premium × 12, plus expected deductible and copays. A cheap Bronze plan can cost more overall if you use a lot of care. See our cost guide.
- Pick the network type that fits how you use care; see HMO vs. PPO.
- Look up the plan’s quality rating on your marketplace (star ratings) or NCQA.
- Check subsidies first. If you qualify for cost-sharing reductions, a Silver plan may be the best value; see our subsidies guide.
Plan metal levels
Marketplace plans come in Bronze, Silver, Gold and (in some areas) Platinum tiers, which differ in how costs are split between you and the plan, not in the quality of care. In 2026, 40% of enrollees chose Bronze, 43% Silver and 17% Gold. Bronze plans have the lowest premiums and highest deductibles, and Bronze and catastrophic plans can now be paired with a health savings account. See our Marketplace guide.
Frequently asked questions
What is the best health insurance company?
It depends on where you live and which doctors you use. Nonprofit and integrated plans, especially Kaiser Permanente, lead NCQA quality ratings, but availability varies by state and county.
Which insurers sell Marketplace plans in the most states?
UnitedHealthcare (30 states) and Centene’s Ambetter (29) in 2026, followed by Oscar (20) and Elevance (18).
Is Aetna still on the Marketplace?
No. Aetna CVS Health left the ACA individual market after 2025. Cigna is leaving after 2026.
What happens if my health insurer leaves the Marketplace?
You’ll need to pick a new plan during open enrollment. Some marketplaces automatically move you to a similar plan if you don’t choose.
How do I check a health plan’s quality?
Use the star ratings shown on HealthCare.gov or your state marketplace, or NCQA’s health plan ratings.
Sources
- KFF – Insurer participation in ACA Marketplaces 2026
- Becker’s Payer – Insurers’ ACA retreat continues (May 2026)
- Healthcare Dive – NCQA 2026 health plan ratings
- Becker’s Payer – Best-rated health plans of 2026 (NCQA)
- CMS – 23.1 million enroll in 2026 Marketplace coverage (Mar 2026)
- BenefitChamps – What changed for 2027 open enrollment (Sept 2026)
- HealthCare.gov – Health plan and network types
Insurance prices, discounts and rules change often and vary by state. Figures were checked in October 2026; confirm details with the insurer or your state insurance department.