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- 650,000people nationally who must pick a new plan for 2027
- 12,000West Virginians in CareSource plans
- Jan 1when your current plan ends, not before
What is happening in West Virginia
In West Virginia, CareSource is leaving the individual market for 2027, affecting roughly 12,000 people. On the marketplace, where subsidies apply, that leaves Highmark Blue Cross Blue Shield and a new carrier, Peak Health, which joins for 2027 in 45 counties.
Prices are moving too. The average approved 2027 increase for people who pay full price in West Virginia is about 14.9%, down from the 17.3% carriers first requested. If you get a subsidy, what you actually pay depends on your 2027 income, not on that number.
2027 in West Virginia: who is selling and what it costs
West Virginia gets a new choice for 2027. Peak Health, a health plan owned by WVU Medicine, Marshall Health and Valley Health, is joining the marketplace. The company says it will sell in 45 of the state's 55 counties and plans to grow in later years. Highmark Blue Cross Blue Shield stays. So most people leaving CareSource will have two marketplace companies to compare, not one. CareSource says members who let their plan renew automatically will be placed with Peak Health or Highmark, depending on where they live.
Highmark asked for an average increase of 18.3% for 2027. The final average for the individual market came in at about 14.9%, according to ACA Signups, which tracks the state filings. Highmark has said it expects its prices and Peak's to land close together.
West Virginia has the highest full price premiums in the country. That is why subsidies matter so much here. In 2026 the average subsidy was $1,244 a month, and the average enrollee paid about $80 a month after it. 55,879 people picked a plan for 2026, down nearly 17% from 2025.
- Platform: HealthCare.gov. Open enrollment runs November 1, 2026 to January 15, 2027. Pick a plan by December 15 for a January 1 start.
- West Virginia has expanded Medicaid.
- If you are in CareSource, check whether your doctors are in Peak Health's network or Highmark's before you let the automatic placement stand.
The national picture
Three carriers account for most of the disruption. This is not a collapse of the marketplace and it is not a solvency problem. In each case the company decided the individual market was not a business it wanted to keep.
Cigna announced on April 30, 2026 that it is exiting the ACA individual market entirely for 2027, on exchange and off exchange, in all 11 states where it sells: Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia. About 369,000 members are affected. Cigna's stated reason was that it saw no clear path to grow the business, alongside a 17% enrollment drop compared with the first quarter of 2025.
Baylor Scott & White Health Plan is leaving the individual market in Texas, affecting roughly 100,000 enrollees, about 2.6% of the state's marketplace.
CareSource is leaving Indiana, Ohio and West Virginia, where it covers nearly 90,000 enrollees, about 60,000 of them in Indiana.
What happens if you ignore the letter
This is the part most people get wrong, so it is worth being precise.
Your current plan runs through December 31, 2026. You are not losing coverage early. But when your carrier leaves, the marketplace does not simply drop you. It automatically moves you into a plan from another insurer that it considers comparable. That process is called crosswalking.
A crosswalked plan is a guess made by a computer on your behalf. It matches on metal level and price band. It does not check whether your doctors are in the new network, whether your prescriptions are on the new formulary, or whether a different plan would have cost you far less once your subsidy is recalculated. People discover those things in February, at the pharmacy counter or the front desk.
The practical point: being auto-enrolled is not the same as being taken care of. If you do nothing, you will have insurance in January. Whether it is insurance that covers your doctors is a separate question, and nobody checks it for you.
The dates that matter
- Fall 2026Non-renewal letters arrive from the exiting carrier. This is the notice, not a cancellation.
- November 1, 2026Open enrollment opens for 2027 coverage. You can compare and choose from this date.
- December 15, 2026Deadline to pick a plan that starts January 1, 2027. Miss this and you can still enroll, but you may have a gap.
- December 31, 2026Your current plan ends. Coverage runs normally until this date.
- January 15, 2027Open enrollment closes. After this you need a qualifying life event.
There is also a special enrollment period. Losing coverage because your carrier left the market is a qualifying life event. It generally opens a 60 day window, which can extend past January 15 if your letter arrived late. If you think you missed everything, ask before you assume.
What to do, in order
Keep the letter
It names your carrier, your plan and the end date. It is also your proof of a qualifying life event if you end up needing a special enrollment period later.
Write down your doctors and your prescriptions
Names of the physicians you actually want to keep, and the exact drugs with dosages. This is the single thing that separates a good plan choice from a bad one, and it is the thing crosswalking ignores entirely.
Re-estimate your income for 2027
Your subsidy is based on your estimated household income for the year ahead, not last year's. If your income changed, your subsidy changes with it, and that can move your real cost more than the plan choice does.
Compare before December 15, not after
Plans are compared on total cost, meaning premium plus deductible plus what you actually expect to use, not on premium alone. The cheapest premium is frequently the most expensive plan for someone who sees a doctor.
Pick deliberately, even if you end up where the crosswalk put you
Sometimes the automatic plan is genuinely fine. The difference is that you checked, rather than found out later.
Common questions
Does my coverage stop the day I get the letter?
No. Your plan runs through December 31, 2026. The letter is advance notice so you have time to choose.
Does this mean my premium is going up?
Not by itself. Your carrier leaving and your premium changing are two separate things. What matters more for what you actually pay is your subsidy, which is recalculated on your estimated 2027 income.
Do I have to use a broker?
No. You can enroll yourself at HealthCare.gov at no cost. A licensed broker also costs you nothing, because brokers are paid by the carriers and the premium is identical either way. Use whichever you prefer, but do not let the deadline pass while deciding.
Is the marketplace itself going away?
No. Other carriers continue to sell in every affected state. Roughly a third of states are seeing at least one exit, which is disruptive for the people in those plans, but the marketplace itself continues.