Which carriers are growing, and which are retrenching, state by state?
Data through March 2026 · Updated May 1, 2026
static extract
Centene shows the fastest tracked enrollment momentum (+14.5% average YoY), while Humana is retrenching (-3.6% across 25 tracked states) despite remaining the largest tracked footprint. Growth and retreat are both strategy, not accident — margin recovery vs share purchase.
Tracked enrollment by carrier (thousands)
Coverage varies by carrier (25 states tracked for Humana, fewer for others) — totals are tracked-state sums, not national enrollment.
State-level detail
| Carrier | State | Enrollment (K) | Plans | Stars | YoY trend | Note |
|---|---|---|---|---|---|---|
| Humana | FL | 1,420 | 18 | 3.5 | -11.4% | Largest Humana market; exiting 6 FL counties in 2026 |
| TX | 780 | 14 | 3.5 | -6.2% | Significant exits in DFW and Houston metro | |
| TN | 412 | 10 | 3 | -2.8% | Strong D-SNP presence via Medicaid alignment | |
| NC | 318 | 9 | 3.5 | -5.6% | Exiting 4 rural NC counties | |
| GA | 298 | 8 | 3.5 | -4.1% | Stable in ATL metro; rural exit ongoing | |
| UHC | FL | 1,820 | 24 | 3.5 | +6.8% | Largest MA market by absolute enrollment |
| CA | 982 | 18 | 4 | +4.2% | LA and SD metros; Kaiser competitive | |
| TX | 842 | 16 | 3.8 | -6.2% | DFW and Houston under pressure from Humana $0-premium capture | |
| NY | 542 | 12 | 4 | +2.8% | NYC metro and upstate markets | |
| OH | 384 | 9 | 3.5 | -4.8% | Columbus book contracting after 2026 plan exits | |
| Centene | TX | 698 | 12 | 3 | +16.8% | Fastest growing in TX via Medicaid alignment |
| FL | 584 | 14 | 3 | +14.2% | Aggressively capturing Humana exits | |
| PA | 112 | 4 | 3 | +12.4% | Gaining in Philadelphia and Pittsburgh via $0 premium | |
| Aetna | FL | 612 | 12 | 4 | +3.4% | Growing in Tampa and Miami |
| TX | 398 | 8 | 3.5 | +2.8% | Houston and Austin markets | |
| PA | 186 | 5 | 4 | +2.1% | Philadelphia metro strength | |
| BCBS | TX | 528 | 9 | 4 | +3.2% | Texas market through HCSC affiliate |
| PA | 342 | 6 | 4 | +2.8% | Highmark dominates Western PA; IBX in Eastern PA | |
| IL | 298 | 6 | 4 | +2.4% | Chicago and suburban IL |
So what / Now what
The 2026 pattern is a deliberate trade: Humana and UHC shed unprofitable membership (exits, benefit cuts) while Centene and regional BCBS buy share. Enrollment momentum diverging from margin strategy means share tables alone mislead — read trend and exits together.
- Competitive benchmarking: use per-state trend rows (table below) rather than national averages; Humana is -11.4% in FL but contesting elsewhere.
- Cross-reference the 2026 plan exits page — carrier 'growth' in exited counties is often crosswalk capture, not organic wins.
- Provider contracting: retrenching carriers renegotiate harder; growth carriers trade rate for network adequacy speed.
Provenance — Carrier footprint by state
- Source file
- CMS monthly enrollment by contract (OEC), March 2026; CMS landscape files
- Vintage
- March 2026
- Last updated
- May 1, 2026
- Refresh cadence
- Monthly (pipeline pending; currently a curated extract)
- Method
- Enrollment in thousands by carrier and state; plan counts, star rating of largest plan, premium/MOOP of flagship product.
- Known limitations
- Curated for major carriers in key states; trend %s are YoY and carrier notes are analyst commentary, not CMS data.