Anthem BCBS is leaving ACA small group market in Ohio
By Susan Morse / June 24, 2026
The exit follows a trend since the end of the enhanced premium tax credits in 2025 and the resulting premium increases and declining enrollments in 2026.
Elevance has confirmed that Anthem Blue Cross Blue Shield is leaving the Affordable Care Act small group market in Ohio. Anthem will continue to serve the individual ACA market in that state.
The insurer said it will discontinue small group ACA plans in Ohio, effective Jan. 1, 2027, and focus its resources on the products that deliver the greatest value and outcomes for employers and their employees.
"Small businesses are increasingly seeking health coverage options that deliver affordability, flexibility and more predictable costs. To meet those evolving needs, we are investing in solutions that have proven most valuable to Ohio employers, including MEWAs (Multiple Employer Welfare Arrangements) and level-funded plans, which serve a majority of our Ohio small business customers," Anthem Blue Cross and Blue Shield in Ohio said by statement.
WHY THIS MATTERS
The insurer's exit in Ohio follows a trend since the end of the enhanced premium tax credits at the end of 2025 and the resulting lower enrollments as ACA premiums increased.
Aetna and Cigna also decided to exit the ACA market.
And Providence Health Plan announced the end of most of its health insurance business, including an exit from the ACA marketplace in Oregon.
Other insurers making such a move include the Baylor Scott & White Health Plan in Texas and CareSource marketplace coverage in Indiana, according to healthinsurance.org.
In May, PacificSource, a health insurer serving the Pacific Northwest, also said it will leave the Affordable Care Act market. PacificSource said it will exit the individual market across all states and will exit the state of Montana across all lines of business.
Without the enhanced ACA subsidies, premiums rose and beneficiaries – especially healthier individuals – opted out of the market, some by simply not paying their January premiums. Enrollment declined, but sicker and more costly individuals were expected to remain on ACA coverage.
However, health insurers significantly expanded off-exchange Affordable Care Act plan offerings in 2026, even as on-marketplace participation declined, according to a Robert Wood Johnson report.
UnitedHealth Group recorded one of the largest expansions, more than quadrupling its off-exchange offerings and entering 20 new states, according to the report. Elevance, Oscar and CareSource also substantially increased off-exchange participation.
Off-exchange offerings now account for more than 40% of all individual market offerings for the first time since 2017.
THE LARGER TREND
A June 8 KFF report said six carriers announced they will exit the ACA marketplaces in plan year 2027, either in some or all states that they are currently offering plans. These include Cigna Health, CareSource, PacificSource, Scott and White, Providence Health and Taro Health, the report said.
These insurer exits are expected to impact roughly a third of states.