Nearly 3 million people with Medicare Advantage plans — or about 10% of all enrollees in the privately managed program — had to seek alternative coverage by 2026 as health insurers exited the market and scaled back plan options, according to a study published Wednesday in a medical journal.
Members in rural areas experienced plan disruptions at twice the rate of those in urban areas, the JAMA study found, raising concerns about loss of access to health care providers, specialty care and long-term treatments, Hannah James, a policy researcher at think tank RAND Corporation, wrote in an editorial accompanying the study.
Across seven states, more than 40% of Medicare Advantage enrollees were left in trouble when plans were terminated, including 92% of Vermont enrollees. The others were Idaho, Wyoming, North Dakota, South Dakota, Maryland and New Hampshire.
The government’s Medicare health program benefits about 60 million people age 65 and older or with disabilities. About half of them enroll in Medicare Advantage plans from major health insurers, while the other half receive benefits from traditional, government-run Medicare.
In 2025, health insurers reported plan shortages after costs rose and government reimbursements fell, and said they would withdraw or shift from the market in 2026.
Unitedhealthcare, Aetna, Elevance all work
The study found that enrollees from smaller insurers represented half of those with disruptions.
UnitedHealthcare, part of UnitedHealth Group, was responsible for nearly 14% of the disruptions, followed by CVS Health’s Aetna and Elevance at 8.65% and about 8%, respectively.
Plans that had offered consumers a greater choice of providers were terminated most often, the study also found.
The current model, in which the government pays insurers on a pre-negotiated basis, incentivizes insurers to attract more profitable patients, James said in her editorial.
“Policymakers should consider whether current program design adequately matches plan incentives to the needs of beneficiaries,” James said.
UnitedHealthcare accounted for nearly a third of all Medicare Advantage plans by 2025, according to health policy firm KFF. Humana, CVS Health and Elevance accounted for 17%, 12% and 7% of plans, respectively.
(Reporting by Amina Niasse in New York; Editing by Caroline Humer and Bill Berkrot)
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