Medicare Advantage (MA) enrollment topped 35 million as of February 2026, but new data from Centers for Medicare & Medicaid Services (CMS) shows the program entering a period of slower growth as insurers adjust strategies amid rising costs, reduced margins, and regulatory pressure.
The MA market is still expanding but far more unevenly than in past years, according to a new KFF issue brief that analyzed the CMS data.
As of February 1, more than 35 million people are enrolled in MA plans, representing an increase of 1.1 million enrollees, or three percent growth year-over-year, KFF said.
While the program continues to attract Medicare beneficiaries, growth has clearly slowed. After rising four percent in 2025, enrollment now sits well below the nine percent annual average seen from 2007 to 2024.
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The overall slowdown masks sharp differences across plan types and insurers.
Special needs plans drive most of the growth
One notable trend: Insurers that have made deliberate investment in special needs plans are seeing a payoff. These plans limit enrollment to individuals with specific chronic conditions or those who are dually eligible for Medicare and Medicaid. The KFF analysis finds that special needs plans accounted for 83 percent of all MA enrollment gains over the past year.
Indeed, more than eight million beneficiaries are now enrolled in these plans, an increase of nearly 900,000 from 2025. Their share of total MA enrollment rose to 23 percent in 2026, up from 21 percent the year prior.
Meanwhile, individual plans only saw a modest growth of 224,000 enrollees, and employer-sponsored group plans experienced a slight decline.
Big insurers see enrollment ups and downs
The 2026 data also reveal significant differences between major players within the MA market.
Only Humana and Kaiser Permanente increased their overall MA enrollment among the five largest insurers. Humana led the market with a gain of 1.2 million enrollees, while Kaiser added 64,000. Both organizations saw growth across all plan types.
Humana’s increase is even more notable when viewed alongside an analysis from Healthcare Dive: the insurer added more than one million members during open enrollment, bringing its total to over seven million—a leap from 5.8 million before the enrollment period began. This positions Humana to potentially overtake UnitedHealthcare as the largest MA insurer. However, the company’s rapid expansion may also pressure profits in 2026.
Meanwhile, KFF said that UnitedHealthcare has lost more than 530,000 MA enrollees since February 2025. Enrollment dropped in different segments: Individual plans saw a decline of 582,000 and group plans dropped 219,000 but the losses were partially offset by the insurer's gain in special needs plan enrollment. Healthcare Dive’s analysis shows that UnitedHealthcare enrolled 9.4 million MA members as of February 2026, a decline of about 900,000 from October 2025 as the insurer pulled back from unprofitable segments and exited certain markets.
Other major insurers also saw losses: Elevance Health is down 368,000 MA members; CVS Health/Aetna lost 29,000, with individual plan enrollment dropping 81,000, and Centene and Elevance, which focused on MA-PD plans, saw declines of four percent and 14 percent, respectively.
Smaller plans gain market share
While the bigger players may be retreating from the MA market, several smaller and mid‑size carriers have gained traction.
According to the KFF analysis, insurers with fewer than one million enrollees collectively added 734,000 MA members in 2026, due to growth across special needs plans, individual plans, and group plans. More than three-quarters of smaller plans that participated in both 2025 and 2026 saw enrollment increase.
Healthcare Dive identified smaller plans that had major enrollment increases. For example, Devoted Health nearly doubled membership from under 210,000 to almost 470,000, while Alignment Health grew 21 percent, from 230,000 to nearly 280,000.