Texas Health System Joins Wave of Medicare Advantage Exits

Houston-based Memorial Hermann Health System announced that its Memorial Hermann Health Plan will cease offering Medicare Advantage coverage after the 2026 plan year, meaning the plan will not be available for 2027. The exit places the system among ten health-system-affiliated insurers that, according to Centers for Medicare & Medicaid Services (CMS) data, are withdrawing from the Medicare Advantage market for 2027.

Newsweek

The departure reflects a larger shift. Becker’s Hospital Review has documented 35 health systems that are terminating network agreements with private Medicare Advantage insurers for 2026, while ten system-affiliated insurers are shutting down their own plans. Other Texas systems, such as CHRISTUS Health Plan, are also exiting, and similar moves are occurring nationwide—including Braven Health in New Jersey, Aspirus Health Plan in Wisconsin, and Providence Health Plan in the Pacific Northwest.

Newsweek

Executives and analysts point to several pressures: competition from large insurers, regulatory uncertainty, and the administrative burden of compliance. Experts also highlight declining reimbursement rates, increasing prior-authorization denials, and the growing cost of serving an expanding Medicare population. These factors, they argue, erode profitability for health-system-run insurers.

Newsweek

With many plans disappearing, beneficiaries must review renewal notices carefully. If they fail to select a new plan by the deadline, they will default to Original Medicare, which lacks a prescription-drug plan and caps on out-of-pocket spending. Financial commentators advise seniors to act promptly to avoid unintended coverage gaps.

Newsweek

• “The system is decoupling right in front of our very eyes. Competition will continue to shrink as many of the providers, such as Humana, UnitedHealthcare, and others, either reduce their services or exit certain Medicare Advantage markets entirely,” — Kevin Thompson, CEO of 9i Capital Group and host of the 9innings podcast

Newsweek

• “Some people say it's because of cost, but we all know it comes down to ‘profits,’” — Kevin Thompson, CEO of 9i Capital Group and host of the 9innings podcast

Newsweek

• “As more insurers reconsider their participation in Medicare Advantage, policymakers will face increasing pressure to balance financial accountability with protecting beneficiaries, while seniors will need to become more proactive in reviewing their coverage,” — Beene

Newsweek

• “Don't be the member who ignores the letter,” — Michael Ryan, finance expert and founder of MichaelRyanMoney

Newsweek