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October 1, 2025
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David Burda
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Consumerism Outcomes System Dynamics
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Sorry, Dr. Oz. The Bloom May Be Falling Off the Medicare Advantage Enrollment Rose

I write about Medicare privatization (you know it by its brand name, Medicare Advantage or MA) a lot as I’m pro healthcare consumer, and no privatization of any government program in the history of the U.S. has ever benefited taxpayers in terms of lower costs for better outcomes. The benefits always accrue to the private companies and executives running the programs on behalf of the government.

Well, years of fooling consumers and ripping off the Medicare program may finally be catching up with the commercial health insurers that run Medicare Advantage plans, according to none other than the Centers for Medicare and Medicaid Services (CMS).

Last week, CMS issued its annual press release telling consumers what to expect from both the MA and Medicare prescription drug programs next year. (You know the Medicare prescription drug program as Medicare Part D.)

Here’s the line in the press release that caught my eye:

“Based on plans’ projections, enrollment in MA is projected to be 34 million in 2026, a decrease from 34.9 million in 2025, with MA enrollment representing approximately 48% of all people enrolled in Medicare, compared to 50% in 2025,” CMS said.

If you’re into this stuff like I am, that’s a bombshell admission from an administration that always claims victory even when it loses and continuously lies about everything.

Increases in MA enrollment and MA’s share of Medicare beneficiary enrollment moving above 50% have been a given for years. If you don’t believe me, read my blog post “Medicare Enrollment Trends in Four Charts” on 4sighthealth.com. Now CMS is admitting to a 2.6% drop in enrollment and a two percentage point drop in market share. Unheard of. And SAD.

That’s especially unsettling news for CMS Administration Mehmet Oz, M.D. (You know him as Dr. Oz.) He’s a big supporter of Medicare privatization, and according to many media reports, at least was an investor in commercial health insurance companies that run MA plans.

CMS did, though, throw its boss a bone, saying, “However, based on recent historical experience and enrollment trends, CMS anticipates that enrollment in MA in 2026 will be more robust than the plans’ projections and that enrollment will be stable.”

Aww. So sweet. Sucking up to the boss is a hallmark of this administration.

That’s what makes the former CMS statement so telling. It tells me that consumers are wising up to the fact that MA plans look for every reason to deny them coverage, and providers are wising up to the fact that MA plans look for every reason to delay or deny their claims for payment.

Maybe their Medicare privatization business model is finally catching up with commercial health plans. Let’s hope so. Sorry, Dr. Oz.

Thanks for reading.

About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personal experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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