Why Insurers Are Leaving Counties and What the 2027 Market Looks Like
Plan terminations are not caused by personal actions. Carriers make corporate determinations to exit specific counties when profit margins compress under federal policy shifts.
Accelerating Market Pullbacks
County-level plan terminations have surged significantly compared to historical baselines. Johns Hopkins researchers found that between 2018 and 2024, only about 1 percent of Medicare Advantage enrollees experienced annual non-renewals.
However, market conditions shifted dramatically entering 2026. Up to 2.9 million enrollees—roughly 10 percent of all individual HMO and PPO members—lost their plans due to carrier exits.
A detailed KFF analysis of CMS data confirms that carrier contractions will persist throughout 2027. Major insurers are paring back county footprints to reduce financial risk.
Insurer Exits Across 2027 Footprints
Several prominent national carriers are shrinking their geographic presence for the 2027 plan year. Health Care Service Corporation is exiting 498 counties, while Centene is withdrawing from 359 counties.
UnitedHealth Group is dropping coverage across 228 counties, and CVS Health (Aetna) is exiting 186 counties. Furthermore, Molina Healthcare and Group 1001 are shutting down their Medicare Advantage business entirely.
These collective carrier pullbacks have expanded coverage deserts in rural areas. For 2027, 193 U.S. counties will have zero general-enrollment Medicare Advantage prescription drug plans, affecting 638,000 beneficiaries.
National Availability and Lower Average Premiums
Despite localized contractions, national access to private plans remains strong. CMS reports that more than 99 percent of Medicare beneficiaries still have access to at least one Medicare Advantage plan in 2027.
Furthermore, 97 percent of beneficiaries can choose among 10 or more plan options. Across the nation, the average beneficiary maintains access to 28 Medicare Advantage drug plans, down from 32 in 2026.
Premium trends also offer encouraging news for consumers shopping in competitive markets. CMS projects the weighted average monthly Medicare Advantage premium will drop by more than 16 percent from 2026 to 2027.
