Several actions have occurred since Epstein Becker & Green, P.C.’s blog post, dated November 19, 2025, regarding state insurance departments scrutinizing Medicare Advantage and MedSupp Trade Practices, which warrants a brief update on this topic.
As a refresher, in October and November 2025, six states issued statements regarding recent Medicare Advantage (“MA”) and MedSupp (or “Medigap”) carrier actions related to enrollment and marketing accessibility, indicating that such actions are considered “unfair and deceptive” under state law – however, without acknowledging preemption principles. Medicare law, which is a federal law, preempts state efforts to regulate Medicare Advantage, except with regards to licensure and solvency. The statements issued by the relevant state insurance departments did not address these areas; therefore, their ultimate applicability and legal effect is questionable.
The Idaho Department of Insurance (DOI), in particular, issued cease and desist letters to two carriers regarding behavior the DOI found to be in violation of such state laws. In response to these actions, both carriers filed suit against the Idaho DOI requesting the Idaho federal district court to enjoin these actions and declare that federal law preempts state law in efforts to regulate Medicare Advantage plans.[1] In late December, the Idaho district court issued a temporary restraining order against the Idaho DOI actions, finding that plaintiff, UnitedHealthcare of the Rockies, was likely to prevail on its argument that the state’s actions are preempted.[2] The court will next have to decide whether to grant a permanent injunction in the case.
CMS tentatively reached the same conclusion as the Idaho district court, having issued on December 4, 2025, just before the end of the annual enrollment period, a statement that “federal law likely preempts state law in such areas”, “including actions related to agent and broker compensation, communication and marketing requirements, and enrollment standards.” Time – and the courts – will tell how these state efforts to regulate MA and MedSupp enrollment and marketing activities will play out. But, despite these recent challenges, MA carriers and broker-agents (and, contracting vendors where applicable) should continue to review their compensation policies, marketing practices, and enrollment procedures to ensure full compliance with state insurance requirements and the MA enrollment process.
EBG is monitoring this closely and will follow with further developments.
Endnotes
[1] See, e.g., UnitedHealthcare of the Rockies, Inc. et al v. Cameron (“UHCR”), Docket No. 1:25-cv-00665 (D. Idaho Nov 21, 2025).
[2] UHCR, Memorandum Decision and Order, Dec. 22, 2025.
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