Why fewer seniors are expected to enroll in Medicare Advantage next year — and opt for original Medicare instead

Medicare Advantage, the private-plan alternative to traditional Medicare, may finally see a hiccup in its blistering subscriber growth.

Enrollment in Medicare Advantage is projected to be 34 million subscribers in 2026, a decrease from 34.9 million in 2025, according to plan forecasts provided by the Centers for Medicare and Medicaid. That marks a drop from 50% of the overall Medicare market in 2025 to about 48% in 2026, CMS said.

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Still, CMS itself expects Medicare Advantage enrollment “will be more robust than the plans’ projections and that enrollment will be stable.” But even “stable” marks a contrast to the growth seen in recent years — Medicare Advantage had 25% of the market in 2010 and has gained market share each year since.

“If enrollment is stable or declines, it would be a break from what we’ve seen for decades,” said Matthew Fiedler, senior fellow at the Center on Health Policy at the Brookings Institution.

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The forecasts come as the open-enrollment period for Medicare approaches — from Oct. 15 to Dec. 7 each year — when beneficiaries can review and update their health and drug coverage for the following year. With the rising cost of healthcare, beneficiaries may look at ways to cut costs. This all comes in the wake of the federal government shutdown, which was triggered in part by a standoff between the two parties as Democrats refused to back a Republican bill they say will make it more difficult for Americans to afford healthcare.

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Medicare Advantage plans offer extra benefits such as vision and dental coverage, but that comes with the trade off of a limited choice of doctors and requirements for specialist referrals. Medicare Advantage also caps annual out-of-pocket costs.

“Medicare Advantage enrollment has grown in tandem with increasing benefit richness in recent years, but carriers are currently focused more on profitability than growth. As MA plan benefits become less generous, we anticipate more seniors may choose original Medicare instead,” said Cobi Blumenfeld-Gantz, chief executive of Chapter, a company that helps subscribers choose Medicare and Medicare Advantage plans.