21 Hospitals and Health Systems Dropping Medicare Advantage in 2026

A list like this is exactly the kind of thing people who dislike Medicare Advantage on principle love to point to as proof the whole system is broken. Before you draw that conclusion, it’s worth stepping back, because the full picture is more complicated than “Medicare Advantage bad, Original Medicare good.”

This kind of network turnover isn’t unique to Medicare Advantage. ACA marketplace plans go through it. Employer group plans go through it. Any time an insurer and a hospital negotiate a contract, there’s a real chance it doesn’t renew on the terms either side wants. Insurance is a business, full stop — and that’s true whether you love or hate Medicare Advantage as a concept.

Here’s the part that gets left out of most “MA is bad” arguments: Original Medicare, on its own, has no annual out-of-pocket maximum. It’s currently the only major form of health insurance in the country without one. That single fact is why Medigap exists at all — without a supplement, a serious hospitalization on Original Medicare alone can genuinely bankrupt someone. If Medicare Advantage didn’t exist and every one of the roughly half of all Medicare beneficiaries currently enrolled in it were pushed onto Original Medicare, most of them would suddenly need to buy both a Medigap policy and a standalone Part D plan — no matter their health or their budget — just to get the same basic financial protection an MA plan already bundles in for free or near-free. A lot of people would lose dental, vision, hearing coverage, and Part B premium givebacks entirely, since none of that comes with Original Medicare on its own.

There’s also a real economic argument for why that shift would backfire. Medigap policies work because the risk pool is manageable. If the entire MA population — a mix of healthy people and people managing real chronic conditions — suddenly needed guaranteed-issue Medigap coverage all at once, without underwriting, that’s a massive, sudden influx of adverse risk into a market that isn’t built to absorb it that fast. Basic insurance math says premiums would rise sharply in response, potentially pricing out exactly the people who most need the coverage.

The ACA is a useful comparison, and not necessarily a flattering one for the “just eliminate Medicare Advantage” argument. Bringing millions of previously uninsured people into ACA marketplace plans was genuinely good for a lot of those people. But ACA premiums have risen essentially every year since, and the people who get squeezed hardest aren’t the ones qualifying for subsidies — it’s working families who earn just a bit too much to qualify for help, but not enough to comfortably absorb rising premiums on their own. And because the ACA reimburses providers at lower rates than Medicare, a meaningful number of doctors limit how many ACA plans they accept. If Original Medicare became the only option for everyone, a similar dynamic could easily follow: lower reimbursement pressure, doctors more selective about which patients they take, and costs shifting onto taxpayers and the middle class through higher premiums, deductibles, and taxes.

The root problem isn’t really which insurance structure we pick. Healthcare costs keep climbing because people are living longer and needing more routine and high-acuity care over more years of life , that’s true regardless of who’s paying the bill. Insurance, at its core, only works when it collects more in premiums than it pays out in claims; that’s not a Medicare Advantage problem, it’s just what insurance is. The more productive conversation, in my view, isn’t “Medicare Advantage vs. Original Medicare” , it’s how we get more proactive, preventive care into the system instead of paying for expensive reactive care after something’s already gone wrong. Until that shift happens at a societal level, we’re going to keep having this same argument about cost, coverage, and quality no matter which system is in place.