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Membership in Health Plans

By October 6, 2025Commentary1 min read

Mark Farrah Associates provides regular reports on enrollment numbers and other measures regarding health plans in the United States.  This report covers the second quarter of 2025.  About 320 million Americans get coverage from a health plan as that time, down slightly from the prior year.  That seems high to me and I suspect double counting of some type.  In any event, Medicare Advantage, by 1.3 million people, individual plans, by 1.3 million members and employer-based self-funded segments, by 1.5 million people, reported increases year-over-year, while Medicaid, by 2.1 million people, and employer risk-based plans, by 1.5 million members, had declines.

Employer self-funded plans covered 133.3 million persons, employer risk plans 48.8 million, Medicare Advantage 34.4 million, Medicaid plans 77.2 million, and individual plans 26.4 million.  As Medicaid expansions during the epidemic are rolled back, there is likely some movement to the individual plans, many of which are sold on exchanges.  The health plan industry is a very large one and is responsible for paying for most of the health care received in the US.   (MFA Release)

Kevin Roche

Author Kevin Roche

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 through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

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  • TimWalzLies says:

    Could be double-counting those with both MA and private insurance. Or those in both at some point over the 12 months. But yeah, 250m seems more realistic.

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