2027: Five million people in Medicare Advantage are losing their coverage

Christopher Rowland and Reed Abelson report for The New York Times on the five million or so people enrolled in Medicare Advantage plans who will have to find new coverage for 2027. While people in traditional Medicare can count on their coverage continuing from one year to the next, people in Medicare Advantage cannot count on continuity of coverage or much else. The private insurers operating Medicare Advantage can and do change their copays and deductibles, their coverage rules and their provider networks.

The big health insurers also terminate their Medicare Advantage plans that they deem unprofitable, as they will. Many people with Medicare will have fewer Medicare Advantage options in 2027. But, that’s not the issue. The question is whether people will have any good options and, unfortunately, no one can answer that question because the data is not available.

The expectation is that more people will lose their Medicare Advantage plans this year than last. They will also be paying higher out-of-pocket costs if they get sick and need substantial care. The insurance brokers are saying that open enrollment will be “volatile.” Hospitals are also dropping Medicare Advantage plans, which can narrow their networks.

Older adults are not likely to be happy with changes to their health plans and higher costs. As it is, many of them struggle to pay for basic necessities. They are now twice as likely to trust that Democrats will address health care affordability issues than Republicans.

While President Trump is sending $90 checks to many people in traditional Medicare, people in Medicare Advantage are not receiving these checks. And, insurers offering Medicare Advantage are unwilling or unable to rein in enrollees’ costs. Instead, they are shifting more costs to their enrollees.

People living in 187 counties, primarily rural areas, will not be able to enroll in a Medicare Advantage plan in 2027. There are 3,069 counties, so it’s a small percentage of the Medicare population. But, it’s up from 118 counties this year. People living in Alaska, as well as some people in New Hampshire, North Dakota and Oklahoma will have no choice of a Medicare Advantage plan. Thank god for traditional Medicare.

Nearly 400,000 people enrolled in a UnitedHealth Medicare Advantage plan are being forced to find other insurance. And, many people are losing some of the extra benefits that lure them into a Medicare Advantage plan. Private insurers offering Medicare Part D prescription drug plans are also dropping out of the market. There were 1,000 of them five years ago. There will be 316 in 2027.

Millions of people will face an additional monthly premium in Medicare Advantage or an increase in the premium they pay. Moreover, average out-of-pocket limits in Medicare Advantage are increasing more than 25 percent from around $5,000 to $6,600. Copays are also going up a bunch, with some people seeing significant increases.

Unlike Medicare Advantage, traditional Medicare, the government administered insurance that covers care from physicians and hospitals across the US, rarely imposes prior authorization rules or second-guesses treating physicians, and has the same costs regardless of where you live in the US. Medicare Advantage plans comes with different costs based on multiple factors, including geographic location.

Much like fire and police, health care coverage is best left in the hands of the government. Traditional Medicare has served older adults and people with disabilities brilliantly over the last several decades. Congress needs to ensure that it is a meaningful option for older adults, people with disabilities and every other American who does not want the volatility and unreliability of corporate health insurance.

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