Time for another of the periodic updates on the enrollment status of the health plan industry, courtesy of Mark Farrah Associates. (MFA Report) Total enrollment across all product lines, based on NAIC reports, was 265.2 million people as of the end of 2017. That is up from 264.3 million at the end of 2016. Administering employer self-funded plans is the single largest segment, at 119.8 million members, but was basically flat year-over-year, growing by around 319,000 people. Risk-based employer plan enrollment was also essentially flat year-over-year, at around 60 million members at December 31, 2017, a decline of 400,000, attributable to ongoing employer shifts to more flexible self-funded plans. Medicaid accounts for about 50 million health plan members (not all Medicaid numbers may be reported through NAIC forms, CMS says about 74 million people have Medicaid and CHIPS coverage, but some of those are in fee-for-service programs), which represents growth of 614,000 recipients from 2016 to 2017. In the last few years this segment has grown very rapidly as states accepted the reform law expansion, but last year’s rise was much lower. The program is a serious budget problem for states, and I would anticipate it will be reduced in future years. Medicare Advantage has shown steady, solid growth, and there were 20.6 million MA beneficiaries at year-end 2017, up from 18.4 million in 2016. As of the start of 2018, MA had another big uptick in enrollment and is now accounts for well over a third of all Medicare recipients. The most troubled segment is the non-group individual one, where the reform law made a complete hash of premiums and plans, with a flawed individual mandate and subsidy design. Premiums in this segment have doubled and enrollment is dropping, with a decrease from 17.3 million at year-end 2016 to 15.6 million in 2015. I would expect further declines, because many of these people don’t need, and don’t think they need insurance, and many others can’t afford the absurd prices. All in all, the industry is in pretty good shape with growth, and is very profitable.
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About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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