As payers retreat from certain markets and rethink benefits in a challenging environment for Medicare Advantage (MA), forced disenrollments for beneficiaries are on the rise, a new study shows.
Researchers led by a team at Johns Hopkins and Georgetown University analyzed enrollment data from between 2017 and 2025 and found that while the forced disenrollment rate was just 1% from 2018 to 2024, that jumped to 6.5% in 2025 as payers reacted to the changing financial calculus in MA.
For 2026, the forced disenrollment rate increased yet again to 10%, according to the study. For non-special-needs plans, the disenrollment rate was 12.5% for the 2026 plan year.
"Millions of Medicare Advantage enrollees will be forced to either find new plans or switch to traditional Medicare in 2026, which may disrupt access to providers and benefits and potentially limit competition in Medicare Advantage," the authors wrote in the research letter, which was published this week in JAMA.
The study also analyzed disenrollments between states and found that, in 12 locations, more than 20% of beneficiaries faced forced disenrollment from their MA plan. This included a high of 92.2% of beneficiaries in Vermont.
Beneficiaries that were most likely to face disenrollment were in PPO plans, plans with lower star ratings or those operated by smaller carriers, according to the study. They were also more likely to be living in rural areas or markets with lower MA penetration.
The study comes as data from the Centers for Medicare & Medicaid Services (CMS) show that while MA enrollment did increase between 2025 and 2026 to 35.5 million beneficiaries, growth is slowing after years of rapid program expansion.
Payer market exits are one of the leading culprits, as the program has been slammed with elevated medical costs and utilization over the past two years. The study authors note that the spike in forced disenrollments coincides with this shift in the market's financial challenges.
The CMS also proposed flat rates for the 2027 plan year, and major insurers have warned this could lead to further benefit cuts and market exits as it does not account for the current trends around cost and service use.
In the JAMA study, researchers also noted that individuals who are forced off of their current MA plan and enroll in traditional Medicare will frequently have worse coverage, as the traditional program has a number of gaps, such as a lack of dental or vision coverage, which MA usually accounts for.