Humana

Humana said 95% of its Medicare Advantage members were enrolled in plans rated four stars or higher for 2027. Healthcare Dive reported that its analysis of CMS data put Humana's corresponding percentage at 93%.

Healthcare Dive reported that UnitedHealthcare was removing about 690 Medicare Advantage plans for 2027. It reported that Humana was removing about 2,400 plans.

With insurers having told investors which 2027 plans will end on December 31, members learn by letter in early October, leaving a window before open enrollment closes on December 7. Those whose plan is terminated get a guaranteed-issue right to buy Medigap if they return to Original Medicare, a protection lost if they simply pick another MA plan.

The Villages Health System agreed to a $541.5 million settlement resolving self-disclosed False Claims Act allegations concerning Medicare Advantage diagnosis codes. The U.S. Department of Justice alleged that unsupported codes increased Medicare Advantage payments; the settlement did not determine liability.

On its second-quarter call CFO Celeste Mellet confirmed that Humana's 2027 plan exits would affect roughly 600,000 members, concentrated in the least profitable plans, most rated 3.5 stars or lower for the 2027 bonus year, while the company expected to recapture a share similar to the 40-plus percent it kept after the 2025 exits. Non-renewal letters go out in September and October.

KFF's annual enrollment update put 2026 MA penetration at 55 percent with UnitedHealthcare and Humana still holding almost half the market, but found enrollment growth slowing sharply, employer and union group plans down by about 31,000, and UnitedHealthcare down nearly 647,000 between March 2025 and March 2026 while Humana gained 1.3 million.

A federal district court granted Clover Insurance partial summary judgment, holding that CMS exceeded its statutory authority in calculating ten star measures and skipped notice-and-comment on ten more, the second court in a year to upend the ratings. Humana cited the decision in its pending Fifth Circuit appeal a week later.

The final 2027 rate announcement raised the net payment update from 0.09 percent to 2.48 percent, about 4.98 percent once expected risk-score growth is counted, mainly by updating the effective growth rate with newer fee-for-service data. Plan stocks rallied, but the update still trailed the 5.06 percent of 2026 and medical-cost trends insurers said were running near 7 percent.

A Healthcare Dive analysis of CMS enrollment files showed 35.5 million people in Medicare Advantage in February 2026 versus 34.4 million a year earlier, growth of about 3 percent against a historical pace of up to 10 percent. UnitedHealthcare fell to just under 9.4 million from 10.3 million before open enrollment; Elevance, Centene and CVS lost 14, 4 and 3 percent of members; Humana was the big gainer.

Humana reported a $796 million fourth-quarter loss but said it had added roughly a million individual MA members during open enrollment, with over 70 percent of new sales switching from competitors, and expected about 25 percent growth for 2026. It guided to lower earnings because of the Bonus Year 2026 star-ratings headwind, with about 45 percent of members in 4-star-plus contracts.

Judge Reed O'Connor ruled that CMS acted lawfully when it downgraded Humana's ratings on the strength of a few failed test calls to its customer service lines, dismissing the case with prejudice. The 2025 downgrade had pushed most of Humana's members out of four-star plans and cost it an estimated billion dollars or more in 2026 bonus revenue; Humana appealed to the Fifth Circuit in late November.

CMS posted the 2026 star ratings on the Plan Finder on October 9, 2025. About 207 MA-PD contracts, 40 percent, earned four or more stars, and the enrollment-weighted average rating edged up to 3.98 from 3.95. The ratings set the 2027 quality bonus payments that feed into the 2027 rate announcement.

As the 2026 plan files went public, UnitedHealthcare confirmed it would leave Medicare Advantage entirely in 16 markets, affecting about 180,000 members, and offer plans in one fewer state and 109 fewer counties. Humana cut 194 counties and three states, and Aetna about 90 plans across 100 counties; Elevance added counties but left the standalone Part D market.

In Humana v. Becerra, the Northern District of Texas granted Humana summary judgment and threw out the 2023 final rule on procedural grounds, finding CMS had changed its justification for dropping the fee-for-service adjuster between proposal and final rule. The decision undercut the extrapolation behind the audit expansion announced in May; CMS appealed to the Fifth Circuit on November 21 and said audits would continue.

Humana said its decision to leave unprofitable plans and counties for 2025 had affected roughly 560,000 members, partly offset by new sales, so it now expected individual Medicare Advantage membership to fall by up to 500,000 for the year rather than about 550,000. The insurer was still absorbing the loss of most of its 4-star-rated membership from the 2025 star ratings.

At an HHS roundtable, Aetna, Humana, UnitedHealthcare, Elevance, Centene, Cigna, Kaiser Permanente, the Blues and AHIP committed to six voluntary reforms across Medicare Advantage, Medicaid managed care and commercial plans: fewer services subject to prior authorization in 2026, real-time electronic approvals and honouring other insurers' decisions by 2027. A year later, KFF Health News found insurers hedging on the promises.