Dive Brief:
- More Medicare Advantage beneficiaries are being forced to find new health plans after insurers exited their markets for 2025 and 2026 due to falling profits and growing turbulence in the privatized Medicare program.
- From 2018 to 2024, the average rate of forced beneficiary disenrollments, or disruptions because a health plan stopped operating in their market, was just 1%, according to the research published in JAMA. But the rate of forced disenrollments rose to nearly 7% last year and 10% in 2026.
- That means millions of enrollees will have to find another MA plan or switch to traditional Medicare, which could limit access to providers and benefits as well as potentially reduce competition in MA, researchers wrote.
Dive Insight:
MA, where insurers contract with the federal government to manage Medicare beneficiaries’ care, has grown significantly over the past 20 years, with more than half of eligible enrollees choosing the privatized option last year.
But MA insurers have grappled with increased medical spending and unfavorable regulatory changes in recent years, pushing payers to exit markets and cut back on benefits in a bid to preserve profits.
For example, UnitedHealthcare, the nation’s largest MA insurer, enrolled about 9.4 million people in the program as of February, down 9% from the number of enrollees recorded in October, according to Healthcare Dive analysis of CMS data released last week.
Overall, nearly 35.5 million people enrolled in MA as of this month, an increase over 2025, but slower growth compared with previous years.
Now, insurers’ MA market exits have increased plan disruptions for beneficiaries — though impact varies by location and plan type, according to the JAMA analysis of HMO and PPO plans across the country.
For example, beneficiaries facing forced disenrollments this year were more likely to be enrolled in smaller carrier plans and those with lower star ratings. They’re also more likely to live in rural areas.
In 12 states, more than 20% of MA enrollees were forced to switch plans, including more than 92% of beneficiaries in Vermont. States like Idaho, North Dakota, South Dakota and Wyoming also had forced disenrollment rates at or above 40%, according to the study.
