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October 4, 2026

Takeaways from the most recent news in the technology and policies shaping healthcare.

Payers

Humana to Exit MA Plans Covering 600,000 Members in 2027

By Healthcare Technology News ·

Humana expects to exit Medicare Advantage plans covering about 600,000 members in 2027, deepening a retreat that reflects mounting cost pressure across the MA business. The move was disclosed on the insurer's July 29 second quarter earnings call, according to Becker's Hospital Review.

CFO Celeste Mellet said Humana will try to hold on to some of those members by steering them into other plans. "We will work to recapture a significant portion of that volume as we did in 2025," she said. In 2025, the company recaptured just over half of the members hit by earlier exits, a benchmark for how much of the 2027 volume it might retain.

The decision fits a broader industry pattern. Insurers are trimming unprofitable MA plans and geographies as medical costs rise and star ratings tighten, prioritizing profitability over raw enrollment. For members, exits mean shopping for new coverage; for providers, they can reshuffle networks and payer mix heading into 2027.

Sources

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Payers

7 Health System Insurers to Exit Medicare Advantage in 2027

Seven health system-owned insurers are among 11 health plans exiting the individual Medicare Advantage market in 2027, with several others narrowing to special needs plans only.

Why it matters: The exits signal that even provider-owned plans are struggling with Medicare Advantage economics, forcing seniors to find new coverage.

Payers

CMS Projects Lower MA Premiums, Flat Enrollment for 2027

CMS projects lower average Medicare Advantage premiums and flat enrollment of 34 million for 2027, a figure that already trails current membership of 36.1 million.

Why it matters: Medicare Advantage now covers nearly half of all Medicare enrollees, so its premium and growth trajectory shapes revenue for insurers, providers, and the federal budget.

Payers

PBMs Become Rare Bipartisan Target in Washington and States

A bipartisan push in Congress and statehouses aims to rein in pharmacy benefit managers, including proposals to force CVS and rivals to split their PBM and pharmacy businesses.

Why it matters: PBMs sit at the center of US drug pricing, and forced divestiture would upend the business models of the largest healthcare conglomerates.