UnitedHealthcare, Aetna and Humana shrink 2027 Medicare Advantage choice; Aetna to shed about 950,000 members

The largest Medicare Advantage insurers are cutting back on plans that let members see doctors outside a set network, Reuters reported on Thursday, as they lay out their 2027 offerings.

• UnitedHealthcare will reduce its preferred provider organization (PPO) plans. A spokesman told Reuters 66% of members will have access to both an HMO and a PPO next year, down from 70% in 2026.
• Aetna, owned by CVS Health, is expanding HMO plans and will sell in 41 states, down from 43. TD Cowen analyst Ryan Langston estimates it will lose about 950,000 enrollees.
• Humana will offer plans in more than 80% of US counties, down from 85%.

"Funding pressures, rising medical costs, rising drug costs, and increased utilization are affecting every part of healthcare," UnitedHealthcare president Bobby Hunter said, according to Reuters. About 34 million people are expected to be in Medicare Advantage plans in 2027, a decline of 6%.

The number behind the number

If 34 million is a 6% drop, this year's base is about 36.2 million, so roughly 2.2 million people are expected to leave Medicare Advantage or lose their plan. Aetna's estimated 950,000 alone would be about 44% of that.

That sits awkwardly next to the government's own headline on 2027 plans. As we reported, CMS projects average Medicare Advantage premiums falling to about $12 a month from $14.37. Both can be true at once. HMOs keep costs down by limiting which doctors a member can use, and that is the direction insurers are moving. A cheaper plan with a smaller network is not the same product as last year's plan at a lower price.

The stocks were little moved by the report. At 2:54 p.m. New York time, UnitedHealth was down 0.9% at $363.81, CVS down 0.7% at $85.14 and Humana down 0.8% at $378.71, according to Nasdaq data.

Who it actually hits: independent practices

The shift lands hardest on doctors who are outside the narrower networks. A PPO member could keep seeing an out-of-network physician at a higher cost share. An HMO member generally cannot. When a patient switches from a PPO to an HMO, or loses an Aetna plan in a state it is leaving, an out-of-network practice can lose that patient on Jan. 1 without anything changing in the exam room.

There are 27,996 independent medical practices listed on CheckThisBiz, with the most in Texas (2,926), California (2,515) and Florida (2,103). For a practice where Medicare Advantage patients are a large share of the schedule, the practical work this fall is checking which of its contracts survive into 2027, and in which plans, before patients make their choices. Patients will be comparing plans in the weeks ahead, and the network lists they read will decide where many of them go next year.

Sources: Reuters via Yahoo Finance; Nasdaq quote data; company filings via SEC EDGAR; business counts from CheckThisBiz. Enrollment arithmetic is a Chronicle calculation. This is market information, not investment advice.