Growth has moved off the annual enrolment period and into the year: January lost 200,688 members, the months since added 756,368. UnitedHealth shed 887,444 lives at the plan-year turn and Humana took on 1,004,716. CVS Health / Aetna is now 0.17 points from overturning a standing claim. The file records 35,751,735 Medicare Advantage lives across 168 parent organisations.
The board
12 parent organisations, 78.6% of Medicare Advantage lives. Gap is year-to-date growth minus the market's, in points. Mix is the product split. Select any row to drill into its county and product detail below.
| Parent organisation | May 2026 | Share | AEP net | YTD net | YTD % | Gap | YTD | Mix | Trend |
|---|---|---|---|---|---|---|---|---|---|
| UNH UnitedHealth | 9,315,193 | 26.06% | -887,444 | -91,722 | -0.98% | -3.14 | |||
| HUM Humana | 7,172,278 | 20.06% | +1,004,716 | +340,595 | +4.99% | +2.82 | |||
| CVS CVS Health / Aetna | 4,188,524 | 11.72% | -119,892 | +81,700 | +1.99% | -0.17 | |||
| KP Kaiser Permanente | 2,054,707 | 5.75% | +602 | +60,505 | +3.03% | +0.87 | |||
| ELV Elevance | 1,899,137 | 5.31% | -308,358 | -27,609 | -1.43% | -3.59 | |||
| CNC Centene | 948,285 | 2.65% | +206 | -16,656 | -1.73% | -3.89 | |||
| HCSC HCSC | 890,719 | 2.49% | -97,612 | +27,184 | +3.15% | +0.99 | |||
| Devoted Devoted Health | 500,912 | 1.40% | +232,835 | +56,855 | +12.80% | +10.64 | |||
| SCAN SCAN Health Plan | 447,746 | 1.25% | +98,605 | +33,520 | +8.09% | +5.93 | |||
| ALHC Alignment Healthcare | 289,395 | 0.81% | +30,860 | +23,786 | +8.96% | +6.79 | |||
| MOH Molina | 225,010 | 0.63% | +15,025 | -10,138 | -4.31% | -6.47 | |||
| CLOV Clover Health | 156,390 | 0.44% | +34,746 | +8,531 | +5.77% | +3.61 | |||
| — Market total | 35,751,735 | 100% | -200,688 | +756,368 | +2.16% | — | |||
Payer strategy — product and county
The plan file says how many. The contract/plan/state/county file says which product and where, and that is where strategy is legible. Below is each carrier's April 2026 product mix, its movement since February 2026, and the shape of its county footprint. Book reassignments are removed from every movement figure; levels are the book as filed.
Contested counties
The counties with the most genuine carrier movement between February 2026 and April 2026, by total absolute change across all parent organisations. Net is the county's own growth; churn is how much moved regardless of direction — a county can be flat and still be a fight.
| County | MA lives | Net | Churn | Biggest gain | Biggest loss |
|---|---|---|---|---|---|
| Los Angeles, CA | 967,679 | +3,369 | 17,147 | SCAN Health Plan +3,231 | Molina -2,063 |
| Miami-Dade, FL | 392,276 | +2,935 | 7,785 | Centene +1,501 | Elevance -992 |
| Honolulu, HI | 113,772 | +103 | 6,809 | Devoted Health +1,666 | Humana -3,340 |
| Orange, CA | 335,725 | +1,586 | 6,526 | SCAN Health Plan +1,790 | UnitedHealth -758 |
| Queens, NY | 253,893 | +1,441 | 6,157 | Visiting Nurse Service of New York +1,764 | UnitedHealth -1,899 |
| Cook, IL | 396,197 | +2,813 | 5,707 | Humana +2,738 | HCSC -991 |
| Bexar, TX | 199,975 | +68 | 5,142 | Humana +1,558 | UnitedHealth -2,091 |
| Harris, TX | 404,460 | +1,530 | 4,756 | Devoted Health +1,102 | UnitedHealth -940 |
| San Diego, CA | 328,773 | +909 | 4,369 | Astiva Health Holdings Incorporated +987 | Molina -451 |
| Riverside, CA | 283,629 | +1,419 | 4,233 | SCAN Health Plan +664 | UnitedHealth -518 |
- Summa Health → General Catalyst Group Management Holdings LP — 32,583 lives across 12 counties
- Renown Health → Kaiser Permanente — 21,356 lives across 2 counties
- UnitedHealth → Visiting Nurse Service of New York — 2,414 lives across 2 counties
Claims check
3 of the standing claims resolve on these counts. Each gauge shows how far the claim sits from the point that would overturn it. The Long View ↗Margin discipline is structural and permanent, not a cycle to wait out.
Overturned if the carriers who announced contraction grow at or above market, through two consecutive annual enrolment periods.
Penetration keeps rising, and it is the insurgents who capture the growth.
Overturned if the insurgent cohort — Devoted, SCAN, Alignment, Clover — grows below market for two cycles.
Humana's announced exit of 600,000 members takes effect in plan year 2027.
Measured as Humana's January 2027 enrolment against its January 2026 baseline. Nothing about the exit is observable until the plan year turns.
C2 C3 C4 C6 — Risk adjustment, star ratings, prior authorisation, distribution consolidation. Not scored here: These resolve in rulings, rule-makings, enforcement notices and earnings language. No enrolment count moves them either way, and a number placed against them would be decoration.
What this page is
Every Medicare Advantage member CMS records, every month — who holds them, which product they sit in, and which county they live in. Figures are Medicare Advantage only: local and regional coordinated care plans, PFFS and MSA. Standalone Part D, employer-only direct-contract PDP, cost plans and PACE are excluded and do not read across to Medicaid, Commercial or Exchange.
Nothing here is an estimate or a projection. The enrolment file is the market's own record of what happened, published about four weeks in arrears, and the page is rebuilt from it the day it lands. Where a standing claim in The Long View can be settled by a count, it is scored above; where it cannot, it is left alone rather than decorated with a number.
Provenance
- Levels and trend — CMS Monthly Enrollment by Plan, 17 files, January 2025 → May 2026.
- Product and county — CMS CPSC Contract/Plan/State/County, February 2026 and April 2026.
- Suppression — CPSC masks any cell of ten or fewer as
*. That is 406,505 lives, 1.14% of the total, reconciled against the plan file. County figures sum unsuppressed cells only, so a plan falling below eleven in a county reads as an exit rather than a decline. - Licence — US Government public domain. No agreement, no cost.
How this page maintains itself
- A scheduled job polls from the 3rd until both files land, checks the column set, row count and total lives against the prior month, then rebuilds this page.
- Product mix, county footprint and the posture lines under each card are all derived from the file. No sentence on this page was written for a particular month except the opening paragraph, and every figure in that was checked back to the data before it shipped.
- Interrupts — a claim test crosses; a carrier moves more than 2% month on month; an offsetting county pair suggests a reassignment; the file is five days late.