2026 Medicare Advantage Enrollment Finally Published
After a long delay, the Centers for Medicare and Medicaid Services finally published results for January and February for Medicare Advantage (MA). While many predicted that the program would contract, I had said that enrollment would be flat or one of the lowest growths we had seen recently. Some analysts suggested that there would be a decline because of the mass exodus of large plans from certain markets and efforts by them to shed huge enrollment.
But despite the huge challenges in the program, MA showed some resiliency. Enrollment in February 2025 was 34.941 million. In December 2025, MA had 35.700 million members. In February, we saw 35.814 million. January numbers showed a contraction from December of about 400K. We know January 2025 numbers had some issues. That could also be the case for January 2026. But February 2025 to February 2026 numbers showed a growth of 873K or 2.5%. The open enrollment slump was not close to the 1M some had said it might be.
It appears that seniors and the disabled continued to see the value of MA compared with traditional Medicare and sought out the best plan they could, including with their existing insurer or smaller and regional players in place of big national plans.
UnitedHealthcare is down over 900K. Humana is up about 1.2M. Elevance Health is down over 300K, with CVS Aetna down over 100K.
#medicareadvantage #enrollment
340B Pilot Is Back
Just a short time after a federal court stayed implementation of the Trump administration’s 340B reform pilot and regulators pulled back the regulation, Trump officials are back with a new proposed version. The Health Resources and Services Administration (HRSA) released a Request for Information (RFI) asking for input on whether and how such a model should be implemented for 340B, which has required drug manufacturers to provide upfront discounts on their products to help subsidize safety-net care. The previous reform proposal converted the concessions to a retrospective rebate.
To address process issues, the RFI calls for input on potential cash-flow impacts, whether participating providers’ reliance on upfront discounts “are reasonable” in light of the government’s statutory authority to implement either “rebate or discount,” and any proposed alternatives and scope-limiting measures.
Under 340B, qualifying providers have paid between 25%-50% less for prescription medications. Many argue that discounts are not passed through to those in need. Studies show that many 340B eligible hospitals essentially pocket the discounts and often have higher overall prices to consumers than those not in 340B.
Additional article: https://www.fiercehealthcare.com/providers/trump-administration-restarts-its-efforts-pilot-340b-rebates
(Some articles may require a subscription.)
#340b #drugpricing #hospitals
https://www.modernhealthcare.com/politics-regulation/mh-hrsa-340b-rebate-pilot-rfi
Humana Adds Providers To Company
Humana completed its acquisition of primary care provider MaxHealth from private equity firm Arsenal Capital Partners. The deal adds 54 primary care clinics, four specialty sites, and 24 affiliated facilities to Humana’s CenterWell services arm. MaxHealth has more than 120,000 Medicare and Medicaid patients as customers.
(Article may require a subscription.)
#primarycare #healthplans #humana
https://www.modernhealthcare.com/insurance/mh-humana-max-health-centerwell
CT Takes Steps Toward Universal Coverage
Connecticut Gov. Ned Lamont has proposed a publicly created, but privately administered, health plan as part of his budget. He is requesting $1 million to outline the policy and conduct a feasibility assessment. He said the state can also explore federal funding opportunities to boost affordability.
The plan includes a tax credit for small businesses using individual coverage health reimbursement arrangements (ICHRAs). The program would have $5 million each year, available on a first-come, first-serve basis. Lamont is also suggesting portable benefits to address challenges with maintaining insurance.
#exchanges #aca #universalaccess #coverage
Judge Stops Blue State Cuts By Trump
The Trump administration has been barred by a federal judge from rescinding $602 million in public health grants from four Democratic-led states. In staying the plan, the judge said the states were likely to succeed in their claim that the action was based on “arbitrary, capricious, or unconstitutional rationales.”
#hhs #cms #trump #healthcare #socialservices
https://thehill.com/policy/healthcare/5737521-judge-blocks-trump-grants-cut
— Marc S. Ryan
