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Policies for the 2026 Medicare Advantage (MA) program were proposed by CMS in mid-January (prior to the inauguration) and will be finalized by early April. CMS indicates that the policies in the Advance Notice would, on average, . However, medical costs for seniors have been rising much more, including estimates of more than last year for enrollees in Medicare Fee-for-Service (FFS) Accountable Care Organizations (ACOs). A preliminary review of CMS growth rate estimates for 2026 also suggests medical costs for enrollees in MA will rise approximately 9% next year.

In contemplating this proposal, it is important to remember that funding for the MA program was cut in each of the last two years – while underlying medical costs have continued to rise substantially. While health plans have worked to shield seniors from the full impact of these cuts, several recent analyses show that MA beneficiaries are already experiencing negative consequences. For example:

• Higher Out-of-Pocket Costs: Although national average premiums declined slightly in 2025, this average masks the widely variable impact nationwide. In fact, beneficiaries in 18 states are experiencing double-digit premium increases and deductibles have more than doubled.
• Reduced Supplemental Benefits: The vast majority of plans continue to include dental, vision, and hearing coverage. However, payment cuts have resulted in reductions in other supplemental benefit offerings for 2025, including higher cost sharing for prescription drugs and cuts to in-home services and transportation benefits.
• Fewer Coverage Choices: As a result of cuts to MA, seniors now have fewer plan options to choose from. In some cases, MA plans have had to exit the market, causing nearly two million beneficiaries to lose their current coverage and forcing them to choose new plans for 2025.

The value of MA is clear and compelling. MA provides seniors better care at lower costs than FFS. MA also performs better on prevention and chronic care management.

• Cost Savings: MA beneficiaries on average in out-of-pocket costs and premiums compared to those enrolled in FFS, and, unlike FFS, MA also caps beneficiaries’ out-of-pocket costs, offering further financial protection.
• Additional Coverage: Most MA plans offer vision, dental and hearing coverage, which FFS does not offer, and two-thirds of MA plans provide prescription drug coverage at no additional premium, whereas FFS enrollees must pay a separate premium for their prescriptions.
• Better Care: MA provides better access to , helping to reduce disease risk and detect illnesses at an early stage, which contributes to MA enrollees experiencing fewer readmissions, preventable hospitalizations, lower rates of high-risk medication use and compared to those in FFS.

These are among the reasons that 34 million seniors and people with disabilities have chosen MA for their Medicare coverage and why MA is particularly valued by seniors living on .

With seniors' usage of medical services expected to remain high, a third consecutive year of insufficient MA funding would cause additional negative consequences for seniors’ benefits, costs and choices in 2026 – while undermining efforts to promote prevention and reduce the incidence and progression of chronic disease.

To keep the bipartisan promise to protect the 34 million Americans who count on this vital part of the Medicare program, MA policies for 2026 should appropriately reflect the expected cost of caring for seniors next year.