While reviewing this year's Obamacare open enrollment information, I put my coffee down. The list of insurers in the Mississippi marketplace had significantly shrunk.

In 2026, there were five options, but only three will remain in 2027. It feels like the menu at a local restaurant has suddenly been cut in half.

According to healthinsurance.org, the remaining insurers in 2027 will be Oscar Health, Ambetter from Magnolia Health, and UnitedHealthcare.

The ones dropping out are Cigna and Molina. However, the situations for these two companies are a bit different.

Cigna is definite. By the end of 2026, it will withdraw from all 11 states where it was selling marketplace plans, and in 2027, it will not sell marketplace plans in any state.

Molina's official announcement is not as clear-cut. There has been no public disclosure of the 2027 rate application for Mississippi, and the company has stated that it will significantly reduce its marketplace presence in 2027.

As a result, industry reports indicate that Cigna and Molina enrollees should choose new plans during this open enrollment. It's essentially advised to prepare for their exit.

For reference, Molina has already announced its exit from the Utah and Wisconsin marketplaces as well. This indicates a trend of the company reducing its overall size.

So, what about the premiums for the remaining three insurers? This is where I put my coffee down for the second time.

The submitted rate increase requests for 2027 are 32.6% for Oscar, 18.6% for Ambetter, and UnitedHealthcare has requested a 25.95% increase, affecting 17,185 enrollees.

Healthinsurance.org estimates that, when weighted, this results in an average increase of 21.8%. This calculation excludes the enrollees from Cigna and Molina who are exiting.

There is an important caveat. These numbers are based on the insurers' submitted requests and may differ from the final approved rates.

It's also noteworthy that the rate increase requests vary by more than 10 percentage points among insurers. When purchasing similar coverage in the same area, if the rate increases differ so much, it becomes a game of comparison.

Ambetter is originally the largest insurer in Mississippi. Reports indicate that it has 142,324 enrollees, accounting for about 45% of the entire marketplace in the state.

As choices decrease, competition also diminishes, and with less competition, the power to negotiate prices decreases as well. This is a practical example of the economics textbook's first chapter playing out in our local insurance premiums.

Personally, I find this somewhat bittersweet. While it's understandable that companies exit due to market logic, the costs ultimately fall on enrollees with tight budgets.

Now, let's get down to business. Mark your calendars.

The Mississippi open enrollment starts on November 1, 2026, and ends on January 15, 2027. To be covered starting January 1, you must select a plan by December 15.

Mississippi does not have its own exchange, so all enrollment, renewals, and plan changes are done through HealthCare.gov. Having a single point of contact is a relief, as it avoids confusion.

If you are a Cigna or Molina enrollee, do not sit idle. If an insurer exits, HealthCare.gov may automatically assign you to another plan, but there's no guarantee that plan will cover your doctors and medications.

Auto-pilot is only reliable in airplanes; in insurance, it's risky. Direct comparison is the best way to save money.

First, check if your current primary care physician and specialists are in the new insurance network.

Second, see if your monthly medications are included in the new plan's formulary. Even the same medication can have different tiers, which can significantly change your out-of-pocket costs.

Third, don't just look at the monthly premium; also consider the deductible and out-of-pocket maximum. There are often many cases in insurance where the cheapest option is not the best.

Fourth, re-enter your expected income for next year to recalculate your subsidy amount. Leaving last year's numbers unchanged can lead to unexpected results.

If you have pre-existing conditions or are undergoing treatment, be sure to consult with your doctor or pharmacist before changing plans. Ensuring continuity of care and prescriptions is a priority.

If English terminology feels overwhelming, you can also find a free navigator on HealthCare.gov. Getting help at no cost is beneficial.

If it were me, I would log into HealthCare.gov this weekend and compare the three options side by side. Delaying until mid-December will coincide with year-end shopping, making it twice as stressful.

Even if insurers leave, we still have to live here. Choosing the least painful option among the remaining choices is the homework for this season.

And I quietly hope that next year, new insurers will return to the Mississippi market. The more options there are, the happier the customers will be.