When CMS proposed to keep Medicare Advantage (MA) payment rates essentially flat for 2027, it raised the possibility that the Trump administration was finally getting serious about its rhetoric of reining in private health insurers. Then the final rule came out last week with a 2.48 percent payment increase worth $13B to MA plans, by doing away with a significant risk adjustment change. Last year, MA enrollment growth slowed significantly, as payers exited markets and cut back on benefits, citing high utilization and adverse regulatory changes. What those headlines obscure is that, even as MA profitability declines, it still offers far better margins than any other insurance product. In 2024, gross margins per MA enrollee were about double that of the employer market. The gap may have narrowed slightly in 2025, but higher utilization was seen in commercial populations as well. Now, with two friendly rate increases recorded under Trump’s CMS, payers and their investors are breathing a sigh of relief. CMS Administrator Dr. Mehmet Oz said during his confirmation hearings that there would be a “new sheriff in town” for MA, but so far, neither the rules around MA payments nor their enforcement have seen much change.