Medicare Advantage: CMS Considers Automatic Enrollment for Beneficiaries

The Centers for Medicare and Medicaid Services (CMS) is considering a policy that would automatically enroll Medicare beneficiaries into Medicare Advantage plans, CMS Director Chris Klomp said Thursday. The proposal, which would represent a significant shift in how millions of Americans access healthcare, was first outlined in the conservative Project 2025 policy blueprint.

Klomp indicated that CMS is evaluating the feasibility of models that would default beneficiaries into either Medicare Advantage, the private option within Medicare, or accountable care organizations participating in the Medicare Shared Savings Program. Beneficiaries would retain the option to choose traditional Medicare if they prefer.

“Would either of those, in my view, be superior to a default enrollment into a fee-for-service arrangement, where there’s not this long-term, secular relationship between the beneficiary, the patient, and their provider? Yes,” Klomp said.

The potential move comes as the Trump administration, led by President Trump and CMS head Mehmet Oz, continues to reshape healthcare policy. Dr. Oz was nominated by President Trump to lead CMS in 2025, following a career as a television personality and surgeon, and his confirmation has been closely watched by healthcare stakeholders. A report from March 20, 2025, noted that Oz’s background is a relative newcomer to the health policy world.

Medicare Advantage plans have been a focus of debate in recent years. In November 2025, changes to regulations governing these plans were projected to result in a $13 billion windfall for insurers, according to reporting at the time. The plans have also faced increasing scrutiny regarding their coding practices and risk adjustment, with concerns raised about potential overpayments. Tara Bannow, a reporter covering hospitals, providers, and insurers, has been tracking these developments.

The proposal to automatically enroll beneficiaries into Medicare Advantage aligns with a long-standing preference for the private option, reportedly held by Dr. Oz, though he indicated openness to more aggressive oversight of those plans during his Senate hearing. The move could significantly alter the balance between traditional Medicare and Medicare Advantage, potentially shifting more beneficiaries into plans administered by private insurers.

In January 2026, the Trump administration announced a modest pay raise for Medicare Advantage plans, a figure some observers deemed insufficient given the program’s size and complexity. The administration, under Dr. Oz’s leadership, also proposed restrictions on how insurers can code illnesses, a move that could impact plan payments.

CMS has not announced a timeline for a decision on the automatic enrollment proposal. Klomp’s remarks suggest the agency is actively exploring the idea, but further details regarding the potential models and implementation remain unclear.