Where is MA penetration highest — and where is the remaining runway?

Q: Where is MA penetration highest — and where is the remaining runway?

MA penetration ranges from 82.1% in Puerto Rico to 31.0% in Alaska; national MA+other share is 57.8% as of February 2026 CMS enrollment data. Penetration above ~60% (FL, AZ, and most of the Sun Belt) means growth must come from switchers, not ageing-in — expect share fights on benefits and broker channels. States in the 40s (HI, VT, AK and much of New England / the Plains) still convert Original Medicare beneficiaries, which favors first-mover network builds.

Data through February 2026 · Updated June 15, 2026 live

MA penetration spans 31% (Alaska) to 82.1% (Puerto Rico), with the national MA-and-other share at 57.8% of 70.8M beneficiaries as of February 2026. The Sun Belt is saturated; the remaining conversion runway sits in New England, the northern Plains, and Alaska/Hawaii.

57.8%

National MA penetration (monthly-file basis)

February 2026

41M

MA & other enrollees

February 2026

Puerto Rico

Highest state · 82.1%

February 2026

Alaska

Lowest state · 31%

February 2026

Top 10 states by MA penetration

Lowest 5 — the conversion runway

Basis: MA + other health plan enrollment ÷ all Medicare beneficiaries, CMS Medicare Monthly Enrollment, February 2026. The plan-year pure-MA basis runs lower (see national trend).

Full data table — all states (52)

#	State	MA enrollees (M)	Total Medicare (M)	Penetration
1	Puerto Rico	0.731	0.89	82.1%
2	Florida	3.398	5.253	64.7%
3	Arizona	1.127	1.778	63.4%
4	Kentucky	0.642	1.046	61.4%
5	Nevada	0.443	0.726	61%
6	New Mexico	0.295	0.487	60.6%
7	Tennessee	0.98	1.62	60.5%
8	Maryland	0.712	1.178	60.4%
9	Indiana	0.831	1.377	60.3%
10	Delaware	0.129	0.215	60%
11	Louisiana	0.571	0.958	59.6%
12	South Carolina	0.757	1.271	59.6%
13	Georgia	1.127	1.893	59.5%
14	California	4.127	6.944	59.4%
15	Ohio	1.721	2.936	58.6%
16	Alabama	0.58	0.991	58.5%
17	Virginia	1.006	1.725	58.3%
18	Mississippi	0.408	0.703	58%
19	Missouri	0.813	1.405	57.9%
20	North Carolina	1.335	2.305	57.9%
21	Colorado	0.634	1.096	57.8%
22	Pennsylvania	1.876	3.245	57.8%
23	Michigan	1.322	2.301	57.4%
24	New Jersey	0.986	1.718	57.4%
25	Arkansas	0.394	0.694	56.8%
26	Connecticut	0.398	0.703	56.6%
27	West Virginia	0.249	0.443	56.2%
28	Washington	0.942	1.68	56.1%
29	Massachusetts	0.817	1.474	55.4%
30	New York	2.179	3.955	55.1%
31	Illinois	1.329	2.416	55%
32	Texas	3.072	5.595	54.9%
33	Rhode Island	0.133	0.243	54.7%
34	Minnesota	0.683	1.253	54.5%
35	North Dakota	0.107	0.197	54.5%
36	Oregon	0.622	1.144	54.4%
37	Wisconsin	0.716	1.319	54.3%
38	Utah	0.32	0.604	53%
39	Oklahoma	0.414	0.799	51.8%
40	Kansas	0.304	0.593	51.3%
41	Nebraska	0.221	0.432	51.2%
42	South Dakota	0.116	0.228	50.9%
43	Iowa	0.349	0.694	50.3%
44	New Hampshire	0.171	0.34	50.3%
45	Idaho	0.194	0.39	49.7%
46	District of Columbia	0.058	0.119	49%
47	Montana	0.138	0.285	48.5%
48	Maine	0.168	0.376	44.7%
49	Wyoming	0.077	0.178	43.2%
50	Hawaii	0.148	0.354	41.8%
51	Vermont	0.065	0.176	36.8%
52	Alaska	0.031	0.1	31%

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Citation: MedicareInsights. “Where is MA penetration highest — and where is the remaining runway?.” CMS Medicare Monthly Enrollment (data.cms.gov, public API), data through February 2026. https://medicareinsights.org/market/ma-penetration-by-state/.

So what / Now what

Penetration above ~60% (FL, AZ, and most of the Sun Belt) means growth must come from switchers, not ageing-in — expect share fights on benefits and broker channels. States in the 40s (HI, VT, AK and much of New England / the Plains) still convert Original Medicare beneficiaries, which favors first-mover network builds.

Sizing a market entry: shortlist states below 50% penetration with positive county velocity — see the fastest-growing counties page for where conversion is actually happening.
Defending share in a >60% state: benchmark your benefit position against the top local carrier before AEP — high-penetration markets are switcher markets.
Download the CSV below for the full 50-state table with enrollee counts for deck-ready sizing.

Provenance — MA enrollment & penetration by state

Source file: CMS Medicare Monthly Enrollment (data.cms.gov, public API)
Vintage: February 2026
Last updated: June 15, 2026
Refresh cadence: Monthly (CMS publishes ~3 months in arrears)
Method: State-level rows pulled from the Medicare Monthly Enrollment API; MA share = MA_AND_OTH_BENES / TOT_BENES. Refreshed via automated pipeline from the CMS public API.
Known limitations: Penetration here is share of all Medicare beneficiaries (Parts A and/or B), not the KFF eligible-only basis, which runs ~4pts higher.