More than 35 Million Seniors Are Counting on CMS to Fully Fund Medicare Advantage. Here’s What’s at Stake.
The Trump administration faces a critical funding decision that could impact millions of seniors.
In the coming weeks, the Trump administration will finalize funding for Medicare Advantage next year — and reliable senior voters are paying attention.
At issue is whether to fix a Medicare Advantage payment rate that independent analysts, bipartisan stakeholders, and the program’s own enrollment data all indicate is inadequate. If the proposed rate is not revised, seniors could face higher costs, reduced benefits, and widespread coverage disruption beginning this October.
Today, more than 35 million Americans are enrolled in Medicare Advantage — over half of all Medicare-eligible seniors. A near-zero payment update when medical costs are rising 7% to 9% a year does not hold the program steady. It functions as a cut. And when payments fall short of actual costs, seniors feel it first: higher out-of-pocket costs, reduced supplemental benefits like dental and vision, narrower provider networks, and in some markets, especially rural ones, exit.
For Sherrie Z. of Myakka City, Florida, who lives on $1,400 a month in Social Security, this represents much more than an abstract policy debate. It is her life. “Without Medicare Advantage,” she says, “I would not be able to go to the doctor because I couldn’t afford it.”
Warning Signs in the Data
The consequences of underfunding are already showing up in enrollment figures and plan design. A peer-reviewed studypublished in JAMA found that nearly one in 10 Medicare Advantage beneficiaries were forced to find new coverage for 2026 because their insurer exited the market, the highest forced disenrollment rate ever recorded — and rural seniors were nearly twice as likely to face that disruption. Avalere’s analysis of the 2026 Annual Enrollment Period tells the same story: Beneficiaries are already seeing fewer plan options, higher out-of-pocket limits, and reduced supplemental benefits. The proposed CY2027 rate would accelerate every one of those trends.
Independent analysis from BRG estimates the proposed rate changes would reduce payments by $324 per beneficiary annually — the result of risk model changes built on flawed 2024 data that has since been corrected. For seniors on fixed incomes, that $324 is the cost of a specialist visit or the vision and hearing benefits that make daily life manageable. BRG also found that every one percentage point added to the effective growth rate would return $144 per beneficiary — a targeted, achievable fix.
“I need my Medicare Advantage. I’m a widow — I don’t have more to pay. It’s my survival. I worked all my life for it.”
— Karen F., Broomfield, Colorado
Voters Are Taking Note
New polling from the Winston Group puts numbers on what seniors are already feeling. By a 43-to-31 margin, voters say the proposed payment rate is inadequate. By more than two to one, they support revising it upward before the Final Rate Notice. A majority of Medicare Advantage seniors say the issue is very important to how they vote — and Medicare Advantage seniors vote at extraordinary rates: in 2024, nearly three in four seniors (74.7%) cast a ballot, the highest turnout rate of any age group, according to U.S. Census data.
The political math is straightforward. Seniors open their plan renewal notices in October. The midterm elections are in November. The rate decisions CMS makes before April 6 will shape what those notices contain — whether premiums hold, whether dental and vision benefits survive, whether the plan a senior has relied on for years is still available in their county. Members of Congress in competitive districts have a clear opportunity to weigh in before that chain of consequences becomes irreversible.
“Being on a fixed income that gets tighter and tighter, Medicare Advantage helps cover those medical bills. I couldn’t exist without it.”
— Jan D., Cottage Grove, Oregon
Putting the Commitment Into Action
CMS has been publicly supportive of Medicare Advantage and accessible to stakeholders throughout this process — receiving a record number of public comments on the Advance Notice and engaging with them during the comment period. President Trump, as recently as the State of the Union, reaffirmed his commitment to protecting Medicare. That commitment now has a test date: April 6.
The path forward is clear: Revise the effective growth rate to reflect actual medical cost trends and delay the risk model changes built on flawed data. For more than 35 million seniors counting on Medicare Advantage, getting the rate right determines whether they can still afford the care they depend on when open enrollment starts in October.