One in 10 Medicare Advantage enrollees were forced to disenroll from their health plan heading into 2026 due to insurer exits from the market, a tenfold increase from historical averages, according to a study published Feb. 18 in JAMA.
The wave of forced disenrollments followed major disruption in the Medicare Advantage market during 2025, when insurers began scaling back their plan offerings amid rising utilization and federal reimbursement changes.
The study’s authors noted that the share of Medicare beneficiaries enrolling in MA has steadily increased over the last two decades, and the number of available plans has doubled over the last seven years, meaning beneficiaries had rarely faced this level of market disruption.
The researchers from Johns Hopkins Bloomberg School of Public Health and Georgetown University analyzed CMS county-level enrollment data, plan crosswalk files and landscape files to identify MA beneficiaries whose plans either terminated their contracts or stopped service in their counties. The sample was limited to non-employer HMO and PPO plans across all 50 states and the District of Columbia. The study captured March enrollment data from 2017 through 2025 and plan crosswalk and landscape files from 2018 to 2026.
Five notes:
1. The mean forced disenrollment rate from 2018 to 2024 was 1%. That rate jumped to 6.9% in 2025 and reached 10% for 2026 coverage. Among non-special needs plans specifically, the 2026 rate was 12.4%.
2. Among the 28.6 million MA enrollees that were part of the study sample, 2.9 million were forced to find new coverage for 2026, while an estimated 25.8 million were able to retain their current plan.
3. Beneficiaries who faced forced disenrollment were more likely to have been enrolled in PPO plans, non-SNP plans, plans from smaller carriers and plans with lower star ratings. They were also nearly twice as likely to live in rural areas or in markets with lower MA penetration. There were no significant differences based on county income, fee-for-service Hierarchical Condition Categories risk score or Medicaid eligibility.
4. The forced disenrollment rate varied by insurer. Smaller insurers grouped under “Other” accounted for 48.8% of forced disenrollments compared to 27.1% of retained enrollees. Blue Cross Blue Shield plans were also overrepresented among forced disenrollments (8.9% vs. 2.9% of retained enrollees). Humana enrollees made up 2.2% of those facing forced disenrollment compared to 18.2% of retained enrollees, and UnitedHealthcare enrollees accounted for 13.9% of forced disenrollments vs. 22.6% of retained enrollees. Aetna (8.7% vs. 7.9%), Elevance Health (8.2% vs. 8.7%), Cigna Healthcare (3.6% vs. 5.2%), Kaiser Permanente (3% vs. 4.3%) and Centene (2.8% vs. 3%) showed smaller differences between the two groups.
5. Twelve states had more than 20% of their MA enrollees facing forced disenrollment. Vermont was the hardest hit, with 92.2% of enrollees affected.
