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Third Quarter 2024 Medicaid Enrollment Continues Downward Trend

 

February 6, 2025

 

 

As of September 30, 2024 (3Q24), total Medicaid enrollment included 77.5 million Americans, representing a year-over-year (YOY) decrease of over 8.3 million enrollees (-9.7%) since the same time the previous year (3Q23). This decrease in enrollment is primarily due to the continued redeterminations and renewals of various state health departments’ “unwinding” plans, following the end of the public health emergency (PHE) on March 31, 2023. When comparing 3Q24 to 2Q24, enrollment fell by over 1.1 million (-1.4%).

  • With the largest Medicaid enrollment by a significant margin, California saw a year-over-year (YOY) decrease in Medicaid enrollment of over 601,000 (k), or about -4.7%. From 2Q24 to 3Q24, California saw a quarterly drop of just under 115k (-0.9%).
     
  • New York, Texas, and Florida Medicaid saw significant declines in YOY enrollment, losing nearly 800k (-11.8%), 676k (-15%), and 625k (-14.8%) members, respectively. The majority of these three states’ declines occurred prior to 3Q24, as their 2Q24-3Q24 quarterly shifts in members were much smaller: New York lost 66k quarter-to-quarter, a loss of -1.1%; meanwhile, Texas saw a quarterly drop of nearly 73.5k (-1.9%) and Florida saw a -0.9% drop of about 33.3k members.
     
  • In terms of percentages, Wyoming saw the single largest quarterly decrease in enrollment, with 5.9% of its members losing coverage, representing just over 3,600 covered lives. Maine saw a 5.5% drop in quarterly enrollment, losing almost 19k enrollees. For notable annual callouts, Colorado saw a YOY decrease of -27% (over 389k members) and Michigan saw a decline of -20.6% (568.7k members).
     
  • While nearly all states saw significant membership decreases throughout the year, a few states did see slight bumps in membership. Alaska, despite losing about 2.4k members over the quarter, had a YOY increase of over 2.6k, or about 1.1%. Year-over-year, North Carolina and South Dakota experienced significant percentage growth, with North Carolina gaining 23.4% in membership (almost 461k enrollees) and South Dakota seeing a 22.9% increase (23.4k enrollees).

Renewals and redeterminations by the federal government have had a tremendous impact on the Medicaid enrollment landscape across the nation. Though total membership continues to decline, the rate of that loss is slowing down and, in some states’ cases, even growing. Evaluating market share in response to these changing metrics will be an important measure of competitive positioning and health plan performance for insurers.

Mark Farrah Associates will continue to monitor enrollment across the country, using County Health CoverageTM and integrating highly relevant sources to provide reliable estimates of health insurance market share at these levels.

About County Health CoverageTM

County Health CoverageTM provides reliable estimates of health insurance enrollment and market share at the state, county, and Metropolitan Statistical Area (MSA) levels. Product features include company market share by county, company, and state for the Individual, Private Group Risk, Private Administrative Services Only (ASO), Managed Medicaid, Medicare Advantage, and stand-alone Prescription Drug Plan (PDP) segments. Breakdowns by product type (HMO, PPO, etc.) are also presented, as well as population demographics and interactive, visual mapping tools. To learn more, visit the product page - County Health CoverageTM.

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™, 5500 Employer Health PLUS, 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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