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Medicare Advantage growth continues to slow as health insurance giants exit the program, shaken by shrinking profits.
Nearly 35.5 million people were enrolled in privatized Medicare programs in February, compared with about 34.4 million people in the same month last year, according to new government data. That’s growth of around 3%, a figure that pales in comparison to MA’s historical growth, which could be as fast as 10% annually.
MA expansion has slowed in recent years as insurers withdraw from the program, spooked by unfavorable regulatory changes and rising medical spending that eats into once-soaring profits.
A Healthcare Dive analysis of CMS data released last week shows how drastically insurers curbed their MA businesses by 2026, doubling down on strategies such as exiting marketplaces and readjusting plan designs to kick unprofitable members out of their plans.
MA’s largest insurer, UnitedHealthcare, enrolled just under 9.4 million people in the program in February, down 9% from the 10.3 million it enrolled in October, before the start of the Medicare open enrollment period.
Similarly, Elevance, Centene, and CVS, three other large MA players, lost 14%, 4%, and 3% of their members, respectively, when looking at local and regional MA plans with prescription drug coverage.
CVS, which offers health plans under its Aetna insurance division, now covers just over 4 million MA enrollees, up from 4.2 million in the fall. Elevance now enrolls 1.9 million members, up from 2.2 million; while Centene’s master’s enrollment has fallen to less than 1 million people.
Humana is the notable exception to the trend. The payer, MA’s second-largest, expanded its presence in the program this year, a move that could result in Humana supplanting UnitedHealthcare as MA’s largest insurer. That would be a blow to the Louisville, Kentucky-based company, which has long played a secondary role to the UnitedHealth division in the privatized Medicare program.
But it’s also a big bet, given forecasts that MA utilization and spending will continue to rise this year.
Humana added more than 1 million additional members to its MA plans, enrolling more than 7 million people in February. That’s up from 5.8 million before open enrollment began.
Still, Humana appears to be trading that growth for lower profits. The company expects to earn $9 in adjusted earnings per share this year, significantly less than analysts expected and about half less than 2025 earnings.
The major nonprofit Kaiser Permanente also expanded its membership, although less dramatically than Humana. Kaiser’s MA enrollees rose 1% compared to the decline, bringing the insurer’s total enrollment to about 2 million people.
Some smaller players also took advantage of the opportunity to recruit more members and cut into the market share of their larger peers.
Devoted Health, a new privately held insurance company, more than doubled its membership during open enrollment, from about 210,000 people to nearly 470,000. Alignment Health, a smaller publicly traded insurer, increased its MA membership by 21%, from 230,000 people to nearly 280,000.
SCAN Group, Aware Integrated, Medica Holding Company and CareSource also saw notable growth in MA enrollment.
Other payers that saw large drops include Blue Cross Blue Shield of Michigan, Health Care Service Corporation and Highmark Health.
Despite the changes in enrollment, the same giants (UnitedHealth, Humana and CVS) still control the majority of the MA market. Still, analysts and executives expect more membership changes throughout the rest of the year, as a separate period for MA enrollees to change plans extends through the end of March.
Other changes in registration would add to the Millions of seniors who have already chosen a new health plan. after being impacted by withdrawals from insurance plans. Medicare enrollment for 2026 was uncharacteristically turbulent, according to brokers, and 2027 could be more of the same, especially if the Trump administration follows through with its plan to keep payment rates stable.
The rate proposal released in January has come under fire from the insurance industry, which argues that MA insurers need a generous payment increase to account for rising medical spending. However, some outside experts argue that MA margins remain high for many insurers and that the rate proposal amounts to a course correction by the government after years of overly generous MA funding.
MA, which continues to cover more than half of all Medicare beneficiaries despite stagnating growth, faces increasing scrutiny for overpayments to health insurers stemming from programmatic incentives for insurers to exaggerate the health needs of their members. This, along with concerns about insurers’ use of restrictive algorithms and networks, has led to calls for MA reform or stricter oversight by federal regulators.
Top Trump administration health officials have been unexpectedly open to such requests, applying stricter risk adjustment standards and reviving more aggressive audits of plan payments.
