Second Quarter Health Insurance Enrollment Trends

September 30, 2019

Mark Farrah Associates (MFA) assessed the latest year-over-year enrollment trends, comparing second quarter 2018 with second quarter 2019 segment membership based on data filed in statutory financial reports from the NAIC (National Association of Insurance Commissioners) and the CA DMHC (California Department of Managed Health Care).  As of June 30, 2019, 267.4 million people received medical coverage from U.S. health insurers.  This number is up from 266.5 million or approximately 825,000 members, from a year ago.  Mid-year enrollment trends indicated membership gains for Medicare Advantage (MA), Employer-Group risk, and Employer-Group ASO (administrative services only for self-funded plans) business, while the Managed Medicaid and Individual segments experienced year-over-year declines. 

• Individual business continued to experience enrollment declines between June 30, 2018 and June 30, 2019. Total year-over-year membership for this segment decreased by 3.0% from nearly 15.4 million enrollees to approximately 14.9 million.  This is a departure of roughly 467,000 million people from the overall individual market. 

• Managed Medicaid membership marginally decreased by 0.9%, or 456,000 enrollees from 2Q18 to 2Q19.  Based on data filed in statutory financial reports, approximately 49.3 million Medicaid beneficiaries received healthcare through Managed Care Organizations (MCOs) in second quarter 2019, but it’s important to note that some plans submit special performance reports to the state and are not required to file NAIC statutory financial statements or to the CA DMHC.  According to the Centers for Medicare & Medicaid Services (CMS), however, over 72.2 million individuals were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) as of June 2019, down 1.2 million since June 2018.  
• The Medicare Advantage market remains strong with continued opportunity for growth, year-over-year. As of June 30, 2019, Medicare Advantage (MA) experienced membership increases as 742,000 more seniors chose an MA plan as compared to the same period a year ago.  According to plan-reported statutory reports, enrollment in MA plans increased from 21.6 million in June of 2018 to over 22.3 million in June 2019. This is a steady increase of 3.4% growth which will most likely continue as an estimated 10,000 baby boomers retire each day.

• Employer-Groups continue to be the leading source of health coverage in the U.S. The latest figures show Employer-Group risk membership, including Federal Employees Health Benefit Plans (FEHBP) enrollment, experienced a slight increase between 2Q18 and 2Q19. Year-over-year membership for the Employer-Group segment marginally increased by 5,766 people as more employers continue to shift towards self-funded (ASO) insurance as a way to reduce costs.
• According to MFA’s recent estimates, Employer-Group ASO (administrative services only for self-funded business) membership grew by close to 1 million members from June 2018 to June 2019.  MFA identified nearly 122.3 million ASO covered lives, which encompassed around 46% of total health enrollment by segment for 2Q19.

About the Data

The data used in this analysis brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database. Employer group ASO figures may be estimated by Mark Farrah Associates using credible company and industry resources.  Individual, Non-Group membership reported by some carriers may include CHIP (Children’s Health Insurance Program).  These adjustments may have resulted in moderate understatement or overstatement of enrollment changes by segment. Findings reflect enrollment reported by carriers with business in the U.S. and U.S. territories.  Data sources include NAIC (National Association of Insurance Commissioners) and the CA DMHC (California Department of Managed Health Care).  As always, MFA will continue to report on important plan performance and competitive shifts across all segments.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry.  Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™.  For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100.

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