CMS has released data on Medicare Advantage enrollment as of the start of 2026 and the Kaiser Family Foundation did an analysis of the changes. There were expectations that enrollment would drop, due to payment and other changes by CMS, but also due to concerns by the health plans about profitability and the fact that many big health plans did drop out of a number of geographic areas. But it turned out that enrollment grew by a million beneficiaries, concentrated among “special needs” plans, which focus on beneficiaries with specific health needs or those who are also eligible for Medicaid. Most of the large health plans want huge profit margins on this business, and they are more likely to get those with the higher payments for special needs plans enrollees.
Medicare Advantage continues to be very attractive compared to fee-for-service Medicare, or FFS Medicare with a Medicare Supplement. The average beneficiary has access to 32 MA plans, most of which have no premium, including for drug coverage, and which offer extra benefits, like vision and dental. Total enrollment is over 35 million now or almost 55% of all beneficiaries. Among the five largest MA players, only Humana and Kaiser increased enrollment. Humana only does MA so they didn’t have much choice if they wanted any member growth. UnitedHealth Group, the largest health plan in MA, declined by almost 600,000 members and Elevance (the old Anthem) by over 250,000. (KFF Analysis)
