SNP Benefits Continue Growth
As more becomes known about Medicare Advantage (MA) 2026 benefits, one trend continues. Special Needs Plan (SNP) investments remain strong. Despite notable MA contraction overall again, SNP benefit packages kept growing for 2026. SNP benefit offerings will grow overall by 33%. Regular MA plans will see a contraction of 9%, with Institutional or I-SNPs dropping 6%. Dual Eligible or D-SNPs will grow by 15% and Chronic Care or C-SNP packages by 42%. D-SNPs still dominate overall numbers in terms of benefit packages and enrollment.
Investments in C-SNPs are occurring as a hedge. C-SNPs carry increased regulatory requirements, but not to the extent of D-SNPs, which are undergoing major integration between the Medicare and Medicaid programs. The growth also is occurring because the ability to have too many SNP “look-alikes” was reined in through a recent rule.
There are a few plans behind this major growth in C-SNPs. Devoted Health is responsible for about half of the C-SNPs growth. They had four C-SNPs in three states and 13 counties in 2025. Now, the plan will have 29 C-SNPs in 978 counties for 2026. Aetna will have 46 plans in 18 states and 242 counties, up from six in two states and 18 counties. Humana will have 74 plans in 26 states and 1,089 counties, up from 64 in 24 states and 1,048 counties. UnitedHealthcare has 97 C-SNPs in 41 states and 2,086 counties for 2026, down slightly from 100 in 42 states and 2,094 counties.
Benefits were trimmed in most SNP plans from 2025 (especially supplemental benefits), but some plans also enhanced benefits.
In other news, here is a partial list of plans that exited MA for 2026:
— Michigan Medicine
— Ochsner Health
— Blue Cross Blue Shield Vermont
— Carle Health, which had Health Alliance and FirstCarolinaCare plans.
— UCare, which had 158,000 MA members across Minnesota and parts of western Wisconsin.
— Samaritan Health Plans, with the exception of D-SNPs.
Additional article: https://www.beckerspayer.com/payer/medicare-advantage/7-insurers-fully-exiting-medicare-advantage/
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#medicareadvantage #specialneedsplans #snps
Government Shutdown Update
The government shutdown will go into next week as the fourth bill to fund the government failed on Friday with the same three Democratic caucus members voting with Republicans. Another vote will be taken on Monday. The House cancelled its votes next week and will stay out of session, signaling no negotiations and putting pressure on Democrats to splinter and support the GOP measure.
House Speaker Mike Johnson, R-LA, sought to reach out to Democrats by saying he would be willing to work on a possible exchange premium subsidy extension in October if the government is reopened. But Senate Majority Leader John Thune, R-SD, poured cold water on the prospects, saying he could make no promises in his chamber. This shows the volatility of the issue in the GOP. Some moderates want the enhanced subsidies extended, while the conservative base in each chamber is opposed.
The enhanced subsidies do seem popular, though. A healthcare policy group KFF survey found that 78% overall believe the tax credits should be extended. And a majority of all political groups supports an extension – 92% of Democrats, 82% of independents, and 59% of Republicans. Even a majority of those who identify with President Trump’s Make American Great Again (MAGA) movement support the subsidies – 57%.
Another KFF analysis finds that Medicaid enrollees in counties where unemployment is at least 8% or 1.5 times the national unemployment rate could be shielded from work requirements when they come in Medicaid in 2027, but only if states apply for an exemption. That likely will not occur in Red or Reddish states. About 1.4 million Medicaid enrollees living in 158 counties could be exempted under that standard or about 7% of the total expansion population subject to work requirements.
Additional articles: https://www.fiercehealthcare.com/regulatory/shutdown-tracker-cms-issues-billing-guidance-hhs-furloughs-32000-employees and https://www.modernhealthcare.com/politics-regulation/mh-aca-subsidies-kff-government-shutdown/ and https://www.beckerspayer.com/research-analysis/over-75-of-adults-want-to-keep-enhanced-aca-credits-poll/ and https://www.modernhealthcare.com/politics-regulation/mh-medicaid-work-requirements-high-unemployment-counties/ and https://thehill.com/homenews/administration/5537289-most-trump-supporters-back-obamacare-subsidies/ and https://www.kff.org/affordable-care-act/5-charts-about-public-opinion-on-the-affordable-care-act/ and https://www.kff.org/quick-take/more-than-3-in-4-aca-marketplace-enrollees-live-in-states-won-by-president-trump-in-2024/ and https://thehill.com/homenews/administration/5536425-live-updates-trump-government-shutdown/
#governmentshutdown #healthcare #coverage #exchanges #medicaid #workrequirements
https://www.modernhealthcare.com/politics-regulation/mh-government-shutdown-aca-subsidies-democrats
— Marc S. Ryan
