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Nearly 3 million Americans were impacted as private health insurers exited markets

Healthcare providers cited rising costs and denied reimbursements as the reason for the shortfalls.
PUBLISHED 2 HOURS AGO
Representative image of a man needing healthcare services. (Cover Image Source: Getty Images | Photo by Justin Sullivan)
Representative image of a man needing healthcare services. (Cover Image Source: Getty Images | Photo by Justin Sullivan)

It was predicted that healthcare costs in the country would shoot up as the Affordable Care Act subsidies came to an end, but few might have predicted the disruptions it would cause to existing healthcare plans. Nearly 3 million Americans faced disruptions in their Medicare Advantage plans as private health insurers exited markets and toned down their operations over financial issues. Naturally, these people only got a small window of time to look for alternative healthcare options.

Representative image of Americans requiring healthcare services. (Cover Image Source: Getty Images | Photo by Joe Raedle)
Representative image of Americans requiring healthcare services. (Cover Image Source: Getty Images | Photo by Joe Raedle)

Private health insurers have seemingly left rural America in droves, leaving such places to face double the rate of disruptions as compared to urban areas, as per a report in Reuters. According to Hannah James, policy researcher at think tank RAND Corporation, this has raised serious concerns over accessibility to healthcare providers, specialty care, and long-term treatments. The report also claimed that seven US states saw 40% of enrollees face such disruptions.

(Image Source: Getty Images| Photo by 	MoMo Productions)
Representative image of a couple having a discussion. (Image Source: Getty Images| Photo by MoMo Productions)

These states include Vermont, Idaho, Wyoming, North Dakota, South Dakota, Maryland, and New Hampshire. Vermont’s case is the worst, as 92% of enrollees have seen their healthcare provider exit the market. A lot of these companies reported shortfalls as the cost of plans increased and the government stopped reimbursing them. This ultimately led to them deciding to pull out of the markets or scale down operations in 2026. As a result, millions of Americans are forced find alternative options. 

Representative image of healthcare workers. (Image credit: Getty Images | Reza Estakhrian)
Representative image of healthcare workers. (Image credit: Getty Images | Reza Estakhrian)

Smaller companies are the ones most affected, but some big names have also contributed to the disruptions. UnitedHealthcare, part of UnitedHealth Group (UNH.N), accounted for nearly 14% of disruptions, followed by CVS Health's Aetna (CVS.N) and Elevance (ELV.N) at 8.65% and about 8%, respectively, as per the report. Commenting on the findings, James noted, "Policymakers should consider whether the current program design adequately aligns plan incentives with beneficiary needs."

A nurse station inside the Clinical Decision Unit (CDU) at Kaiser Permanente's Capitol Hill Medical Center in Washington, DC. Kaiser's CDU allows patients to avoid the frequent delays associated with a typical hospital emergency room. Kaiser members receive immediate care from clinicians, doctors and specialists on site, who have access to patients' complete electronic medical records. On the left is Darryl Richardson, RN, and on the right is Doctor Jasmin Valentin.|Getty Images|Photo by Brooks Kraft LLC
A nurse station inside the Clinical Decision Unit (CDU) at Kaiser Permanente's Capitol Hill Medical Center in Washington, DC. Kaiser's CDU allows patients to avoid the frequent delays associated with a typical hospital emergency room. Kaiser members receive immediate care from clinicians, doctors and specialists on site, who have access to patients' complete electronic medical records. On the left is Darryl Richardson, RN, and on the right is Doctor Jasmin Valentin.|Getty Images|Photo by Brooks Kraft LLC

While these disruptions are throwing people into a scramble, some may be lucky enough to receive compensation from a specific healthcare provider. Earlier this year, Kaiser Foundation Health Plan Inc. lost a class action settlement worth a whopping $10.5 million. The settlement was over marketing text messages sent to people after they had asked the company to stop doing so, which was in violation of federal and Florida laws.

Representative image of the U.S. Supreme Court at dusk (Image source: Getty Images/Photo by Drew Angerer)
Representative image of the U.S. Supreme Court at dusk (Image source: Getty Images/Photo by Drew Angerer)

The Telephone Consumer Protection Act (TCPA) and similar state laws allow people who receive such unwarranted communications to receive direct payments. However, the company has denied any wrongdoing. "As part of the proposed Settlement, Kaiser does not admit to any wrongdoing and continues to deny the allegations against it. The Court has not decided who is correct," a statement read. The order covers two groups of people who received constant text messages between January 21, 2021, and August 20, 2025.

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