A peer-reviewed study published in JAMA in February 2026 found that the share of Medicare Advantage enrollees forced out of their health plan jumped to 10 percent nationally heading into this year’s coverage, roughly ten times the historical average. In 12 states, more than one in five Medicare Advantage members had no choice in the matter at all: their insurer either dropped the plan’s contract with Medicare or pulled out of their county, leaving them to pick a new plan or default to Original Medicare. For a retiree living on a fixed income, an involuntary plan switch can mean a new drug formulary, a different network of doctors, or a premium that no longer lines up with what was budgeted for the year.
Vermont was the extreme outlier, with more than nine in ten Medicare Advantage members there losing their plan. The disruption traces back to insurers pulling out of smaller and rural markets as medical costs climbed and federal payment growth slowed.
Inside the Johns Hopkins-Georgetown Study of Forced Switches
Researchers from the Johns Hopkins Bloomberg School of Public Health and Georgetown University built the analysis from Centers for Medicare & Medicaid Services county-level enrollment data, plan crosswalk files, and landscape files, tracking non-employer HMO and PPO Medicare Advantage plans across all 50 states and the District of Columbia. The study captured March enrollment figures from 2017 through 2025 alongside plan files running from 2018 to 2026, letting the authors measure how often members were forced out of a plan year over year rather than relying on a single snapshot.
What they found was a sharp break from the historical pattern. From 2018 through 2024, the average forced-disenrollment rate held steady at about 1 percent a year. That rate jumped to 6.9 percent heading into 2025, then reached 10 percent for 2026 coverage — 12.4 percent among non-special-needs plans specifically. Of the 28.6 million Medicare Advantage enrollees in the study’s sample, 2.9 million were forced to find new coverage for 2026, while an estimated 25.8 million were able to keep their existing plan.
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Twelve States Crossed the One-in-Five Mark, Led by Vermont’s 92%
The national number obscures how unevenly the disruption landed. Twelve states had more than 20 percent of their Medicare Advantage enrollees facing forced disenrollment for 2026, and Vermont was by far the hardest hit, with 92.2 percent of its Medicare Advantage members affected — a level of disruption the study’s authors said stood apart from anything in the prior seven years of data they reviewed. The dividing line was not just geography: beneficiaries who were forced out disproportionately held PPO plans, non-special-needs plans, and coverage from smaller carriers with lower star ratings, and they were nearly twice as likely to live in a rural county as beneficiaries who kept their plan.
Rural, PPO and Smaller-Carrier Members Bore the Brunt
The insurer-by-insurer breakdown in the study shows why the disruption fell so unevenly. Smaller carriers grouped under an “other” category accounted for 48.8 percent of forced disenrollments, compared with 27.1 percent of enrollees who kept their plan. Blue Cross Blue Shield plans were also overrepresented, making up 8.9 percent of forced-out members versus 2.9 percent of those who stayed put. The two largest national insurers showed the opposite pattern: Humana enrollees made up just 2.2 percent of forced disenrollments compared with 18.2 percent of retained enrollees, and UnitedHealthcare enrollees were 13.9 percent of forced disenrollments versus 22.6 percent of retained enrollees. The researchers found no significant differences in forced disenrollment tied to county income, health risk scores, or Medicaid eligibility — the split ran along plan type, carrier size, and geography instead.
Most Displaced Members Found Another Medicare Advantage Plan
A separate analysis released in March 2026 by KFF, the nonpartisan health policy research organization, looked specifically at Medicare Advantage plans that ended their contracts at the close of 2025 — a narrower slice of the same disruption, measured differently than the JAMA study above — and found that most of the affected 2.6 million beneficiaries had somewhere to go. Ninety-eight point nine percent had at least one other Medicare Advantage prescription drug plan available for 2026, with an average of 25 options in their area, and more than two-thirds could stay with a plan from the same insurer. Just 1.1 percent of beneficiaries in a terminated plan — fewer than 30,000 people nationwide — had no Medicare Advantage option left at all. Vermont was again the exception: two of the state’s insurers withdrew entirely, and KFF found that more than two-thirds of Vermont enrollees whose plan was terminated had no Medicare Advantage alternative for 2026, leaving Humana as the only carrier still selling plans in the state.
What a Plan Termination Triggers Under Medicare’s Rules
Federal rules give affected beneficiaries a formal window to act rather than leaving them to sort it out alone. Under Medicare’s Special Enrollment Period rules, when a plan’s contract with Medicare isn’t renewed, members can switch anytime between December 8 and the last day of February the following year. When a plan or Medicare ends a contract outside that annual cycle, the window opens one to two months before the contract ends and stays open for one to two more months afterward. Anyone who doesn’t choose a new Medicare Advantage plan during that window is automatically enrolled in Original Medicare, which does not include the extra dental, vision, and hearing benefits many Medicare Advantage plans offer.
The Payment Pressure Behind the Pullbacks Continues Into 2027
Insurers have pointed to rising medical costs and slower federal payment growth as reasons for narrowing their Medicare Advantage offerings, and the pattern has not reversed. The Centers for Medicare & Medicaid Services finalized its 2027 Medicare Advantage rate announcement in April 2026, setting an average payment increase of 2.48 percent for plans — a figure the industry has said falls well short of the growth in the medical costs plans are covering. With bids for 2027 already submitted, the same pressures that pushed the 2026 forced-disenrollment rate to a record are still in place heading into the next Annual Enrollment Period.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
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