Medicare Payment Advisory Commission insights, Congressional reports and enrollment data have all been released in the early months of 2026. Some methodology has been questioned by insurers and CMS, even directly on the Congressional floor.
Despite the challenges, here are nine data points to know about where Medicare Advantage stands in 2026 — and where they come from:
1. CMS is increasing MA payments by 2.48%, or more than $13 billion, according to its finalized rate for 2027. The announcement came April 6, marking a jump from the 0.09% MA rate change proposed in January.
2. The Elevance Public Policy Institute published a March 23 study on MA enrollment and total Medicare spending. If a 10-percentage-point increase in MA penetration was linked to 1.5% lower total Medicare spending per capita, cumulative savings from 2012 to 2021 are estimated to have been $111 billion, compared to if MA penetration held steady at 2011 levels. After adjusting for coding intensity — yielding a 1.1% spending reduction, instead — estimated savings would have been $83 billion.
3. Medicare Advantage payments will be 14% more than traditional Medicare in 2026, equating to $76 billion, according to MedPAC’s March report.
4. MA enrollment has been diversifying, according to research in the American Journal of Managed Care. For example, special needs plan enrollees increased from 2.6% to 14.8% from 2012 to 2022.
5. The Congressional Joint Economic Committee determined Medicare Part B premiums shouldered an additional $13.4 billion in 2025 due to Medicare Advantage overpayments.
6. A Feb. 26 report from HealthScape Advisors and Chartis found MA enrollment grew 2.5% this year, reaching a record 35.4 million beneficiaries, despite the growth rate shrinking from 2025.
7. The same report showed that MA enrollment dropped in seven states for the first time: Vermont, Wyoming, New Hampshire, Idaho, Minnesota, Maryland and South Dakota.
8. One in 10 MA enrollees needed to disenroll from their plans due to insurer exits going into 2026, according to a JAMA study.
9. A January Health Affairs Scholar analysis, which CMS leaders contributed to, identified a roughly 2% differential between Medicare Advantage and original Medicare coding for 2022, whereas MedPAC estimated a 10% gap.
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