Nearly 3 million Medicare Advantage enrollees had to abandon their health plans this year after insurers exited markets or terminated contracts, setting a record for forced disenrollment. Researchers at Johns Hopkins Bloomberg School of Public Health found that 1 in 10 Medicare Advantage members faced involuntary plan loss in 2026, the highest rate in at least a decade of tracking. The disruption hits hardest in counties where fewer private plan options exist, raising urgent questions about whether affected seniors can find comparable coverage without gaps in care.
Record forced disenrollment and what drove it in 2026
The scale of this year’s plan exits dwarfs anything in the recent past. A Johns Hopkins study using national Medicare Advantage enrollment and plan data from 2017 through 2026 calculated that 1 in 10 enrollees were forced out of their plans. The researchers relied on publicly available CMS files that track every contract, plan, and enrollment change at the state and county level, allowing them to distinguish normal consumer switching from true involuntary loss of coverage.
When an insurer pulls a plan from a county, affected members do not simply lose a brand name. They lose established provider networks, drug formularies, and supplemental benefits they may have relied on for years. Seniors with chronic conditions or ongoing specialist relationships face the steepest burden because switching plans often means restarting prior authorizations, navigating new utilization review rules, or finding new doctors who accept different network terms. For low-income enrollees, even modest changes in copays or deductibles can push needed care out of reach.
One factor that helps explain the concentration of exits is how CMS sets payment benchmarks for Medicare Advantage. Those benchmarks are tied to local fee-for-service Medicare spending. In counties where fee-for-service costs have declined or grown slowly, benchmark payments to private insurers also fall, squeezing plan margins. Insurers operating on thin margins in those markets have less financial cushion to absorb rising medical costs, making exit a rational business decision even if it strands thousands of enrollees. The hypothesis that forced switches spike after benchmark updates take effect aligns with the geographic pattern the Johns Hopkins researchers identified, though the publicly available CMS enrollment files do not include fields that directly link terminations to specific benchmark changes.
Industry consolidation and product strategy also play a role. Some insurers have moved to simplify their portfolios by dropping smaller plans or counties where they lack bargaining power with hospitals and physician groups. Others have shifted toward products with narrower networks or more aggressive utilization controls, betting that healthier beneficiaries will tolerate the restrictions while sicker patients are more likely to be left searching for alternatives.
CMS data confirms the 2026 enrollment picture
CMS maintains a detailed repository of enrollment data broken out by contract, plan, state, and county. Those files serve as the denominator for calculating disenrollment rates and allow independent verification of how many members were enrolled in plans that later disappeared. The April 2026 monthly enrollment file, the most recent available, confirms overall Medicare Advantage participation levels and provides plan-level detail that can be cross-referenced against terminated contracts and service areas.
The data show wide geographic variation. States with smaller, more rural populations and fewer competing insurers tend to have higher rates of forced switching because a single plan exit can eliminate the only private Medicare option in an entire county. Affected beneficiaries in those areas may have to fall back on traditional fee-for-service Medicare, which lacks the out-of-pocket caps and supplemental dental or vision coverage that many Medicare Advantage plans bundle in. In urban counties, by contrast, multiple insurers often continue to operate, but exits can still narrow networks and increase travel times for specialty care.
The Johns Hopkins analysis underscores that these are not isolated, one-off events. Over the study period, a substantial share of beneficiaries experienced at least one forced plan change, suggesting that instability is becoming a structural feature of the Medicare Advantage marketplace rather than an occasional disruption.
Open questions about coverage transitions and next steps for enrollees
Several gaps in the available evidence limit a full accounting of what happens after forced disenrollment. CMS enrollment files track where people start and end each month, but they do not capture how many beneficiaries experience delays in care, change medications, or lose access to long-standing clinicians during the transition. Nor do they reveal how many enrollees simply forgo coverage altogether for a period because they find the switching process confusing or miss key deadlines.
The Johns Hopkins researchers note that some displaced beneficiaries successfully move to other Medicare Advantage plans, while others enroll in traditional Medicare with or without supplemental Medigap coverage. For low-income seniors and people with disabilities, the interaction with Medicaid is especially important. The federal Medicaid program can help cover premiums and cost sharing for those who qualify, but eligibility rules and benefits vary widely by state, and navigating dual enrollment is complex even in the best of circumstances.
Advocates argue that more robust outreach and counseling are needed when plans exit. State health insurance assistance programs, Area Agencies on Aging, and community organizations often step in to help beneficiaries understand their options, but their capacity is limited relative to the scale of the 2026 disruptions. Clearer, earlier notices from insurers and CMS could give enrollees more time to compare alternatives, verify that their doctors are in network, and confirm that critical drugs remain on formulary.
Policymakers are also weighing longer-term responses. Some proposals would adjust benchmark formulas to reduce volatility in low-spending counties, while others would strengthen requirements for network adequacy and continuity of care when plans terminate. Consumer groups have called for automatic special enrollment protections and extended transition supplies of medications for anyone forced out of a plan mid-treatment.
For now, beneficiaries facing a plan exit are urged to act quickly once they receive notice. Reviewing the Medicare & You handbook, contacting local counseling resources, and checking eligibility for financial help through state-specific Medicaid offices can all help reduce the risk of coverage gaps. As the 2026 experience shows, the stability of Medicare Advantage coverage cannot be taken for granted, and the burden of navigating change still falls heavily on older adults and people with disabilities who can least afford disruption.
