7 Health System Insurers to Exit Medicare Advantage in 2027

The retreat from Medicare Advantage is accelerating. Seven health system-affiliated insurers are among 11 total health plans leaving the individual MA market for 2027, according to CMS data reported by Becker's Hospital Review.

Some payers are not exiting outright but narrowing their footprint. Molina Healthcare, Horizon Blue Cross Blue Shield of New Jersey, New York City-based MJHS Health System's Elderplan, and Albuquerque-based Presbyterian Health will stay in MA next year only through special needs plans, which serve specific populations such as dual-eligible or chronically ill members.

The moves reflect mounting financial pressure on MA. Rising medical costs, tighter CMS reimbursement, stricter risk-adjustment rules, and higher utilization have squeezed margins across the industry. Health systems that launched their own plans to capture premium dollars and coordinate care are finding the economics harder to sustain. For the seniors enrolled in these plans, the exits mean shopping for new coverage during open enrollment and potential disruptions to existing provider relationships.