Health and Tech Now weekly: 4.3 million people on Medicare lose their plan Dec. 31

This is this week’s Health and Tech Now weekly issue, sent Tuesday, Nov. 3, 2026. Get it in your inbox every Tuesday, free: subscribe on Substack.

Every source link below was reopened on Mon Nov 2, 2026 between 4:10 and 4:35 PM CT.

Opener

4.3 million people on Medicare will lose their plan on Dec. 31, KFF counted on Oct. 27 (KFF, Oct. 27, 2026). People who keep their stand alone drug plan will pay an average of $51 a month in 2027, up from $34 (KFF, Oct. 30, 2026). Open enrollment ends Dec. 7.

Roundup

Medicare. Insurers will end the plans of 4.3 million Medicare enrollees on Dec. 31: 3.1 million in Medicare Advantage drug plans and 1.2 million in stand alone drug plans. One drug plan, SilverScript Choice, holds 950,000 of them (KFF, Oct. 27, 2026). KFF projects the average stand alone drug plan premium rises 50%, from $34 to $51 a month, for people who stay put (KFF, Oct. 30, 2026). Our stories: plans ending and drug plan premiums

Medicare and AI. Under WISeR, Medicare’s AI prior authorization pilot, epidural steroid injections fell 15.0% and other targeted services fell 19.5% in the first six months (JAMA, Oct. 26, 2026). Bid applications posted by EFF show two bidders named Palantir as a partner. Zyter, the WISeR vendor for Arizona, wrote that Palantir supports Humana and Aetna. Fleet Health wrote that Palantir serves Humana, Cigna and Blue Shield of California. These are claims in applications, not contracts (EFF records, Oct. 27, 2026; CMS WISeR page, checked Nov. 2, 2026). Our stories: the JAMA study and the Palantir records

Health insurers. CVS Health sued CMS on Oct. 26 over its 2027 star ratings. It says the ratings put more than $2 billion in 2028 bonus and rebate money at stake for plans covering about 7,033,760 members (CVS complaint, S.D. Ga., Oct. 26, 2026). Centene filed its own suit on Oct. 22 and puts its loss at about $448 million (Centene complaint, S.D. Ga., Oct. 22, 2026). Our story

ACA coverage. Centene reported 3,403,300 marketplace members, down from 5,828,100 (Centene Q3 results, Oct. 27, 2026). CMS canceled marketplace coverage for 760,000 people in anti fraud actions (CMS fact sheet, Sept. 22, 2026), and 13 Senate Democrats sent letters to 10 insurers about it on Oct. 27 (Sen. Wyden, Oct. 27, 2026). Our stories: Centene and the senators’ letters

ACA prices. Benchmark silver premiums rise 13% on average for 2027, after 26% for 2026, KFF found (KFF, Oct. 30, 2026). CMS says more than 75% of HealthCare.gov buyers will still have a plan at $50 a month or less (CMS fact sheet, Oct. 30, 2026). Signup opened Nov. 1. Our story

Hospitals. HCA Healthcare says more uninsured patients cut about $400 million from its third quarter pretax income. Same facility emergency room visits rose 5.1% (HCA Form 8-K, Exhibit 99.1, Oct. 27, 2026). Our story

Health tech. HHS published the HTI-5 final rule on Oct. 28, and it takes effect Dec. 28. It removes the AI “model card” requirements for certified health IT. HHS puts the savings at $1.55 billion in present value, or $108.1 million a year (Federal Register, Oct. 28, 2026). Our story

Drugs and policy. Eli Lilly’s third quarter revenue rose 39% to $24.4 billion. Volume rose 53% and realized prices fell 15% (Lilly, Oct. 29, 2026). A final Labor Department rule makes PBMs disclose rebates and other pay to large self insured employer plans, which cover about 90 million Americans. The department projects up to $22 billion in lower drug costs over 10 years (DOL, Oct. 29, 2026). Our stories: Lilly and the PBM rule

Women’s health. The FDA removed heart disease, breast cancer and dementia from the boxed warning on 3 more estradiol patches. Six products got the same change in February, and 29 drugmakers have filed label changes (HHS, Oct. 30, 2026). Our story

What it means

Our read, drawn from the Roundup above.

For company leaders. Coverage losses now show up in the results. HCA tied about $400 million in lost pretax income to more uninsured patients. Centene’s marketplace book is about 2.4 million members smaller. ACA benchmark premiums rise another 13% in 2027, so budgets for next year should assume more uninsured patients.

CVS and Centene took the 2027 star ratings to court. Together they claim more than $2.4 billion in 2028 bonus and rebate money. Until a judge rules, the published ratings stand.

In its first six months, WISeR cut epidural steroid injections in traditional Medicare by 15%. Two bidders wrote that their partner Palantir also works for Humana, Aetna and Cigna. HTI-5 drops the federal model card rule on Dec. 28, so hospitals that want AI disclosures must write them into vendor contracts.

For sellers. Medicare Open Enrollment ends Dec. 7. The new plan must get the request by then for coverage on Jan. 1 (Medicare.gov, checked Nov. 2, 2026). KFF counts 4.3 million people whose plan ends Dec. 31. Expect calls from clients holding a non renewal notice.

Clients who keep a stand alone drug plan face an average premium jump from $34 to $51 a month. Every drug plan client should compare 2027 options before Dec. 7.

People whose plan’s contract isn’t renewed can still switch from Dec. 8 to the last day of February, per Medicare.gov. On the ACA side, Dec. 15 is the last day to pick a plan for Jan. 1, and the period ends Jan. 15 (HealthCare.gov, checked Nov. 2, 2026). Clients in traditional Medicare in WISeR states will ask why some procedures now need approval.

For members. If your Medicare plan ends Dec. 31, pick a new plan or you go to Original Medicare on Jan. 1. Your plan’s notice names the date. To have a new plan on Jan. 1, the new plan must get your request by Dec. 7. If you miss that, you can still join a plan through Feb. 28, per Medicare.gov.

If you have a stand alone drug plan, check its 2027 premium. KFF projects the average for people who stay put at $51 a month, up from $34. Compare plans on Medicare.gov or call 1-800-MEDICARE.

If you buy coverage on HealthCare.gov, pick a plan by Dec. 15 for Jan. 1. CMS says more than 75% of buyers can find a plan at $50 a month or less. If you use an estradiol patch, the warning label changed; ask your doctor what it means for you.

The number

$51. The average monthly premium KFF projects for a stand alone Medicare drug plan in 2027 for people who keep the plan they have, up 50% from $34 (KFF, Oct. 30, 2026).

The tracker

Plan Exit Watch. Medicare Advantage members in plans that end Dec. 31 and don’t roll into a 2027 plan, by state. Counts only, no carriers.

State	Members in ending plans	Share of individual MA members	Source
Minnesota	344,313	62.4%	CMS, Oct 2026
Florida	320,430	11.4%	CMS, Oct 2026
New York	242,431	13.2%	CMS, Oct 2026
Texas	200,898	8.9%	CMS, Oct 2026
Maine	67,883	34.0%	CMS, Oct 2026
Illinois	62,567	7.7%	CMS, Oct 2026
Oklahoma	16,179	5.1%	CMS, Oct 2026

Source: CMS 2027 Plan Crosswalk (Oct. 1, 2026) and CMS enrollment by contract, plan, state and county (October 2026). County pages: Minnesota, Florida, New York, Texas, Maine, Illinois and Oklahoma.

Since last week

Stories we updated after new filings or facts came in. Each link goes to the updated story.

Centene sues CMS over 2027 star ratings What changed: the story now adds the CVS Health suit filed Oct. 26 against the same 2027 ratings. CVS complaint, S.D. Ga., Oct. 26, 2026.

Dates ahead

Medicare dates for the weeks ahead. Each one has one thing to do.

Dec 7: Medicare Open Enrollment ends. The plan must get the request by Dec 7 for coverage that starts Jan 1. Call every client whose plan ends before then. Your state’s Plan Exit Kit is now part of the Group plan and Enterprise.

Source: Medicare.gov, Joining a plan, checked Nov 2, 2026.

Dec 8 to Feb 28, 2027: members whose plan’s contract isn’t renewed can still switch. Anyone who joins no plan is in Original Medicare. Work the clients who missed Dec 7. The AEP 2027 Agent Sales Playbook covers this window, $49.99: get the Playbook

Source: Medicare.gov, Special Enrollment Periods, checked Nov 2, 2026.

Jan 1, 2027: 2027 coverage starts. Check which counties lost the most members to plan exits before you plan January calls. Every county in up to 3 states, monthly, on the Group plan.

Source: Medicare.gov, Joining a plan, checked Nov 2, 2026.

Jan 1 to Mar 31, 2027: Medicare Advantage Open Enrollment. People already in a Medicare Advantage plan can switch plans or go back to Original Medicare. Review every new client in January. Pro for agents sends a new Playbook edition each season, first one Dec 8, $99 a month: Pro for agents

Source: Medicare.gov, Joining a plan, checked Nov 2, 2026.

Next week

• Nov. 6: Humana reports third quarter 2026 results at 6:00 a.m. Eastern, with a call at 8:00 a.m. (Humana, Oct. 12, 2026).
• Nov. 9: Hims & Hers reports third quarter 2026 results (Hims & Hers).
• Nov. 15 to 18: HLTH USA in Las Vegas (HLTH).
• Dec. 15: comments close on the CMS proposed rule on provider directories and PBM accountability (Federal Register, Oct. 20, 2026).
• Dec. 28: the HTI-5 final rule takes effect (Federal Register, Oct. 28, 2026).

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Health and Tech Now is an independent publication. Views are not those of any employer. Public sources only. Every story links its primary source. Nothing here is medical, legal, financial or plan enrollment advice.