Just shy of about 35.5 million seniors were enrolled in Medicare Advantage plans, per new federal data, representing another year of slim growth in the program.
MA enrollment has grown rapidly over the past decade, with the program eclipsing more than 50% of Medicare-eligible beneficiaries. However, growth of late has stagnated as costs continue to rise and major players exit certain markets to address this challenge.
For comparison, enrollment in MA was about 34.4 million on Feb. 1, 2025, according to data from the Centers for Medicare & Medicaid Services.
Within that 35.5 million, 31.6 million are enrolled in Medicare Advantage Prescription Drug (MAPD) plans. In addition, 8.2 million MA members are in a special needs plan, a growing area of focus for many insurers in this market. Special needs plans include coverage for dually eligible individuals and those with chronic conditions.
The Medicare Advantage market has been a financial growth engine for the largest players as enrollment increased, but has been an anchor around the neck of major companies over the past two years as medical costs and utilization rise.
Multiple leading payers in MA, including the biggest insurers in UnitedHealthcare, Humana and Aetna, departed certain markets and tightened benefits in response. For UHC and Aetna, that led to a decline in membership this year, while Humana saw a surprise spike in enrollment during the annual window.
The company revealed during its fourth-quarter earnings call that it added about 1 million members during the annual enrollment period and expects to carry that momentum through the rest of 2026. Executives told investors that its membership could grow by more than 25% this year.
Given the cost pressures in this market, whether enrollment growth at this scale will prove beneficial to Humana as other payers retreat remains to be seen.
The continuing slowdown in MA enrollment growth overall also comes at a time when insurers are scrambling to respond to proposed 2027 rates, which CMS is aiming to keep essentially flat to 2026. The top brass at all three leading MA plans said this does not reflect the reality of costs in this market.
Despite a likely lobbying blitz to adjust the rates, analysts at Capstone said in a report last week that they don’t expect CMS to budge significantly on the proposal. For one, regulators are well aware that MA tends to be more profitable than commercial plans or managed Medicaid coverage.
In addition, industry players have a history of overstating the margin impact of policy changes, Capstone said.
“The Trump administration remains skeptical of claims that MA plans are operating in financial distress, and will continue to look toward risk adjustment as ripe for significant reform in future rulemaking,” the analysts wrote.
That said, the analysts noted that while significant relief around rates isn’t likely, there is some room for the feds to offer relief to plans, particularly around risk adjustment models and member risk assessments.
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