This is the fourth consecutive year that Cigna has grown its Medicare portfolio, according to the announcement. The Connecticut-based payer now offers at least one $0 premium MA plan in every market, while most of its customers will pay the same or cheaper premiums compared to last year.

Despite previously lagging in the market, Cigna is now among the fastest-expanding MA providers, along with peers Molina and Alignment Healthcare, according to a Bank of America analysis of CMS data released late last month.

Molina added four new states after adding 10 last year, while Alignment expanded into Florida and Texas.

Meanwhile, large incumbents like UnitedHealthcare, Humana, CVS Health-owned Aetna and Elevance are modestly expanding their total addressable markets. Centene is slightly paring back growth, and insurtech disruptors like Oscar, Bright and Clover are materially slowing or even contracting growth to refocus on margins, according to BOA.

CMS expects a slowdown in overall MA growth for 2023, forecasting 6% growth down from the 10% expected this year. That’s partially explained by some managed care companies pulling back — and because CMS has also generally underestimated MA growth, the BOA analysts said.

Enrollment in MA plans, which cover Medicare Parts A and B benefits while offering supplemental benefits like dental and fitness, continues to increase, with projections estimating enrollment will reach almost 32 million people next year.

Enrollees say they like the plans because of their affordability, coverage and convenience, while plans tout that they’re saving the government money while keeping consumers healthier. However, data on that claim is mixed, and concerns are rising that MA plans are gaming the payment system by making their patients appear as sick as possible, resulting in a slew of recent lawsuits.

According to congressional advisory board MedPAC, average MA bids last year were 15% lower than what traditional Medicare pays for fee-for-service enrollees. However, Medicare spends 4% more on MA enrollees than those in traditional Medicare, making the program lucrative for payers.

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