Medicare Advantage Enrollment Faces Another Slow Growth Year

Nearly 35.5 million senior citizens were enrolled in Medicare Advantage (MA) plans, according to newly released federal figures, marking another year of modest expansion for the program.

Over the past decade, MA participation has climbed steadily, surpassing 50% of individuals eligible for Medicare. More recently, however, growth has slowed as rising medical expenses and cost pressures have prompted several major insurers to withdraw from select markets. By comparison, enrollment stood at approximately 34 million as of February 1 last year, based on data from the Centers for Medicare & Medicaid Services.

Of the roughly 35.5 million current enrollees, 31.6 million are signed up for Medicare Advantage Prescription Drug (MAPD) plans. Additionally, 8.2 million beneficiaries participate in special needs plans, an area drawing increasing attention from insurers. These plans serve populations such as individuals eligible for both Medicare and Medicaid and patients managing chronic health conditions.

While Medicare Advantage had previously been a significant source of revenue growth for large insurers, the past two years have presented financial strain as healthcare utilization and medical costs have risen. In response, several leading MA carriers, including UnitedHealthcare, Aetna and Humana, have scaled back their geographic footprints and reduced benefits in certain areas. UnitedHealthcare and Aetna experienced membership declines this year as a result, whereas Humana reported an unexpected enrollment surge during the annual sign-up period.

During its fourth-quarter earnings call, the company disclosed that it added approximately 1 million members during the annual enrollment cycle and anticipates sustaining that momentum throughout the rest of this year. Executives indicated to investors that membership could expand by more than 25% this year.

As cost pressures rapidly increase in the Medicare Advantage market, it remains uncertain whether Humana’s rapid enrollment gains will ultimately translate into financial benefit, particularly as other insurers scale back their participation.

The broader deceleration in MA membership growth is unfolding as insurers work to respond to proposed 2027 payment rates from CMS, which are expected to remain largely unchanged from what they are this year. Executives at the three largest MA carriers have argued that the proposal fails to adequately account for rising medical expenses in the program.

Even with what is expected to be an aggressive lobbying effort to secure higher rates, analysts at Capstone indicated in a report last week that substantial revisions from CMS are unlikely. Regulators, they noted, recognize that Medicare Advantage generally generates stronger margins than commercial insurance or managed Medicaid products.

Capstone also pointed out that insurers have historically overstated the financial impact of regulatory adjustments. The analysts wrote that the Trump administration continues to question assertions that MA plans are under significant financial strain and is likely to pursue further reforms to risk adjustment in upcoming rulemaking.

Still, while major changes to payment rates appear improbable, the analysts suggested there may be limited opportunities for federal officials to provide targeted relief, particularly in areas such as risk adjustment methodologies and member risk scoring practices.

Medicare Advantage Enrollment Trends in 2026

Medicare Advantage enrollment is projected to experience another year of slower growth in 2026, signaling a shift in the long-standing expansion of private Medicare plans. For more than a decade, Medicare Advantage plans have steadily gained beneficiaries, but recent data suggests that growth momentum is beginning to moderate.

After years of rapid expansion, enrollment in private health plans serving seniors is expected to post another modest increase in 2026. The pace of sign-ups has slowed compared to the double-digit growth seen earlier in the decade, reflecting changing financial conditions, regulatory adjustments, and shifting consumer preferences.

Industry analysts note that while overall participation continues to rise, the rate of expansion has tapered as the market becomes more saturated. With a majority of eligible seniors already enrolled in private options, year-over-year gains are naturally moderating.