As many as 2.9 million Medicare Advantage (MA) enrollees face forced disenrollment in 2026, according to researchers at the Johns Hopkins Bloomberg School of Public Health. That figure represents roughly one in ten people enrolled in MA plans nationwide. Insurers are pulling out of counties across the country, leaving seniors to find replacement coverage during open enrollment or shift into traditional Medicare at a time when federal regulators say the broader market should hold steady.
Why 2.9 Million Forced Disenrollments Demand Attention Now
The tension at the center of this disruption is a direct conflict between two official accounts of the same market. The Centers for Medicare & Medicaid Services (CMS) released 2026 plan information for Plan Finder and stated that Medicare Advantage programs are expected to remain stable in 2026. At the same time, independent analysis of the agency’s own enrollment files tells a different story. Researchers at Johns Hopkins found that as many as 2.9 million enrollees are tied to contracts that will not be renewed, forcing those beneficiaries to act before coverage lapses.
The gap between “stable” and “2.9 million affected” matters because it shapes how seniors respond. A beneficiary who reads a federal press release about market stability may not realize their specific plan is terminating. Those who do not actively choose a new MA plan during open enrollment will be moved into traditional Medicare by default, potentially losing supplemental benefits like dental, vision, or hearing coverage that MA plans often bundle in. For low-income and medically complex beneficiaries, losing these extras can translate into higher out-of-pocket costs or forgone care.
One question worth tracking is whether counties with the largest enrollment drops between 2025 and 2026 also show disproportionate movement into traditional Medicare rather than other MA plans. CMS publishes monthly enrollment files by state, county, and plan type, which would allow researchers to measure that pattern in near real time. If the trend holds, it would suggest that in markets where insurers exit, seniors are not simply switching to a competitor but leaving the MA system altogether.
CMS Data, Johns Hopkins Findings, and the VBID Model’s End
The 2.9 million estimate comes from analysis of primary CMS datasets, including monthly enrollment files and the 2026 Part C and D Plan Crosswalk. The crosswalk maps plan identifiers across contract years, making it possible to distinguish genuine terminations from administrative changes like plan ID consolidations. According to the Johns Hopkins team, the affected enrollees are concentrated in counties where insurers chose not to renew contracts for the coming year, rather than in areas experiencing routine plan reshuffling.
Researchers also point to the calendar as an underappreciated driver of disruption. The 2026 plan year will be the first after the scheduled conclusion of the Value-Based Insurance Design (VBID) model test, a multi-year demonstration that allowed Medicare Advantage plans to offer targeted benefit enhancements and cost-sharing reductions for certain enrollees. Some insurers had leaned on VBID flexibilities to differentiate their products or manage high-need populations. With the model ending, those organizations may see fewer financial or regulatory advantages to staying in marginal counties, especially rural areas with smaller risk pools.
At the same time, CMS finalized its Contract Year 2026 rule, designated CMS-4208-F, which updates Star Ratings calculations, dual-eligible special needs plan requirements, and Part D benefit structures. While the rule does not directly order any plan to exit, it tightens oversight and adjusts payment-linked quality measures. For plans already operating on thin margins, a tougher ratings environment or new compliance investments can tip the balance toward leaving certain markets rather than absorbing additional risk.
The interaction between these regulatory shifts and insurer strategy helps explain why forced disenrollment is not spread evenly. Counties with high proportions of dual-eligible beneficiaries, limited provider networks, or historically low Star Ratings appear more vulnerable to contract non-renewals. In those communities, a single national carrier’s decision to withdraw can wipe out the majority of local MA options in one stroke, converting what looks like a “stable” national market into a localized coverage crisis.
What Beneficiaries and Policymakers Should Watch Next
For beneficiaries, the immediate task is vigilance. Seniors enrolled in affected contracts will receive non-renewal notices, but those mailings often arrive amid a flood of marketing materials. Advocates warn that clear, early communication from health plans, state health insurance assistance programs, and community organizations will be essential to prevent gaps in coverage or unintentional loss of supplemental benefits.
For policymakers, the 2.9 million figure is an early indicator rather than a final tally. Enrollment patterns during the upcoming open enrollment period will show whether displaced beneficiaries cluster in a small number of replacement plans, spread across many competitors, or default into traditional Medicare. Each scenario carries different implications for risk selection, plan solvency, and future premium levels.
Finally, the apparent contradiction between CMS’s assurances of stability and the Johns Hopkins findings underscores a broader issue of transparency. National averages can obscure sharp regional contractions. As the 2026 plan year approaches, aligning federal messaging with on-the-ground realities will be critical to ensure that the seniors most at risk of losing coverage understand both their exposure and their options.
