Medicare Advantage growth continues to slow as health insurance giants pull back on the program, rattled by shrinking profits.
Almost 35.5 million people were enrolled in the privatized Medicare programs as of February, compared with about 34.4 million people in the same month last year, according to new government data. That’s growth of about 3%, a figure that pales in comparison to MA’s historical growth, which could be as rapid as 10% annually.
MA’s expansion has decelerated in recent years as insurers retreat from the program, spooked by unfavorable regulatory changes and rising medical spending cutting into once sky-high profits.
A Healthcare Dive analysis of the CMS data released last week shows just how drastically insurers pumped the brakes on their MA businesses for 2026, doubling down on strategies like exiting markets and rejiggering plan designs to push unprofitable members out of their plans.
The largest MA carrier, UnitedHealthcare, enrolled just shy of 9.4 million people in the program as of February — down 9% from the 10.3 million it enrolled in October, before the start of Medicare’s open enrollment period.
Similarly, Elevance, Centene and CVS, three other large participants in MA, dropped 14%, 4% and 3% of their members, respectively, when analyzing local and regional MA plans with prescription drug coverage.
CVS, which offers health plans under its Aetna insurance division, now covers just north of 4 million MA enrollees, down from 4.2 million in the fall. Elevance now enrolls 1.9 million members, down from 2.2 million; while Centene’s MA enrollment has fallen to under 1 million people.
Humana is the notable exception to the trend. The payer, the second-largest in MA, expanded its presence in the program this year — a move that could result in Humana supplanting UnitedHealthcare as the largest MA insurer. That would be a coup for the Louisville, Kentucky-based company, which has long played second fiddle to the UnitedHealth division in the privatized Medicare program.
But it’s also a significant gamble, given forecasts that MA utilization and spending will continue to increase this year.
Humana brought more than 1 million additional members onto its MA plans, enrolling more than 7 million people in February. That’s up from 5.8 million before open enrollment kicked off.
Still, Humana appears to be trading that growth for lower profits. The company expects to make $9 in adjusted profit per share this year, significantly lower than analysts expected and down about half from 2025’s earnings.
Major nonprofit Kaiser Permananente also expanded its membership, albeit less dramatically than Humana. Kaiser’s MA enrollees are up 1% compared to the fall, bringing the insurer’s total enrollment to about 2 million people.
Some smaller players also took the opportunity to nab more members and cut into the market share of their larger peers.
Devoted Health, a privately held insurance startup, more than doubled its membership over open enrollment, from about 210,000 people to almost 470,000. Alignment Health, a smaller publicly traded insurer, increased its MA membership by 21%, from 230,000 people to almost 280,000.
The SCAN Group, Aware Integrated, Medica Holding Company and CareSource also saw notable MA enrollment growth.
Other payers that saw large declines include Blue Cross Blue Shield of Michigan, Health Care Service Corporation and Highmark Health.
Despite the enrollment shakeups, the same giants — UnitedHealth, Humana and CVS — still control the lion’s share of the MA market. Still, analysts and executives expect further membership shifts over the remainder of the year, given that a separate period for MA enrollees to switch between plans runs through the end of March.
Further enrollment changes would come on top of the millions of seniors that already chose a new health plan after being impacted by insurer plan exits. Medicare enrollment for 2026 was atypically turbulent, according to brokers, and 2027 could be more of the same — especially if the Trump administration follows through on its plan to keep payment rates flat.
The rate proposal released in January has been attacked by the insurance industry, which argues that MA insurers need a generous payment hike to account for rising medical spending. However, some outside experts contend that MA margins remain high for many insurers, and that the rate proposal amounts to a course correction from the government after years of overly generous MA funding.
MA — which continues to cover more than half of all Medicare beneficiaries despite stagnating growth — is facing rising scrutiny for overpayments to health insurers stemming from programmatic incentives for insurers to exaggerate their members’ health needs. That, along with concerns about insurers’ use of algorithms and restrictive networks, have given rise to calls for MA reform or stricter oversight from federal regulators.
Top health officials in the Trump administration has proved unexpectedly open to such asks, pursuing tighter risk adjustment standards and resuscitating more aggressive audits of plan payments.
