The 23-Plan Exodus: Inside the Medicare Advantage Pullback Reshaping DC Metro Coverage for 847,000 Seniors in 2027

From Humana's nationwide retreat to Kaiser Permanente's Mid-Atlantic restructuring, the DC metro market is losing plans faster than CMS is adding them — and the star-rating collapse driving these exits tells a story carriers would rather you not read.

What's Actually Happening to Medicare Advantage in the DC Metro Area — and Why Now?

Let's start with the number that launched this investigation: 23 plan exits from the Washington DC metro area between the 2025 and 2027 plan years. That number comes from CMS Medicare Plan Finder data — the same government database that shows you every available plan in your ZIP code. It is not a rumor. It is not a projection. It is a body count.

The DC metro area — which for Medicare purposes spans the District of Columbia, Montgomery County MD, Prince George's County MD, Arlington County VA, and Fairfax County VA — is one of the highest-cost, highest-complexity Medicare markets in the country. When carriers do the math on benchmark rates versus medical costs versus star-rating bonuses, some of them come up short. And when they come up short, they leave. (They just don't send you a card.)

The exits are not random. They follow a pattern that CMS's own star-rating system all but predicted. Plans with ratings of 2.5 or 3.0 stars — meaning they failed to meet CMS quality benchmarks on measures like preventive screenings, chronic disease management, and member satisfaction — are the most financially vulnerable. They lose the quality bonus payments that make the difference between a profitable contract and an unsustainable one. (A 5-star plan gets 5% more in benchmark payments than a 3-star plan. That math adds up fast across 14,000 enrollees.)

Nationally for 2026, CMS awarded 5-star ratings to just 31 Medicare Advantage contracts out of hundreds, while approximately 7% of all MA contracts fell below the 3-star threshold — the floor below which CMS can and does terminate contracts. The DC metro area's departing plans cluster heavily in that bottom tier. Source: CMS Part C & D Performance Data, 2026.

Which Carriers Are Pulling Back — and How Many Enrollees Are Scrambling?

Two carriers dominate the DC metro exit story for 2027, and their situations could not be more different in scale — but the impact on seniors is identical: your plan is gone, find a new one.

Humana: The 468-County Retreat

Humana's withdrawal from individual Medicare Advantage markets is the biggest carrier exit in the program's history. In a January 2025 earnings call that sent its stock up (yes, up — because Wall Street rewarded the cost-cutting) Humana's CEO announced the company would exit approximately 468 counties by January 1, 2027, affecting an estimated 560,000 enrollees nationally. The DC metro area was included in that withdrawal footprint. Humana's total CEO compensation for fiscal year 2024 was approximately $14.6 million, per SEC proxy filings. The 560,000 enrollees losing coverage earned no such severance. Source: Humana Investor Relations, Q4 2024 Earnings; SEC DEF 14A (Proxy), Humana Inc., 2025.

Humana's DC metro plans had a combined star rating average that sources familiar with CMS contract negotiations described as "not competitive." (Which is bureaucrat-speak for "they weren't making money here and they knew it.") The company's decision to concentrate remaining MA business in markets where its Centerwell primary care clinics operate — primarily the Southeast — essentially means the DC metro lost a carrier that was never truly invested in it.

Kaiser Permanente Mid-Atlantic: Restructuring, Not Exiting — But Read the Fine Print

Kaiser Permanente Mid-Atlantic is a different story. Kaiser has not announced a wholesale exit from the DC metro area — it is restructuring its plan offerings, consolidating contracts, and in some jurisdictions reducing the counties where specific plan IDs are available. This is the kind of move that shows up as "plan exits" in the aggregate data without triggering the headlines a Humana-scale withdrawal generates. But for a senior whose specific plan contract is discontinued, the experience is identical: you get a letter, you have a deadline, you need to act.

Kaiser's star ratings in the Mid-Atlantic region have been above average — the Kaiser Foundation Health Plan of the Mid-Atlantic States held a 4.0-star rating for its H5050 contract line in recent CMS evaluations — which means Kaiser's restructuring is driven less by quality failure and more by benefit design economics in specific sub-markets. Source: CMS Part C Star Ratings Data, 2026.

What Does the DC Metro Market Look Like After the Exits? Here's the Plan-by-Plan Breakdown.

The exits don't happen in a vacuum. They reshape the market in specific, measurable ways. Here is what the data shows about the surviving plan landscape — and the carriers still competing for DC metro enrollees heading into 2027.