After the current administration allegedly caused billions of Americans, including illegal immigrants, to lose their health insurance coverage, I thought it would be worth summarizing the most recent Mark Farrah Associates report on health plan enrollment to see how bad the carnage actually was. As of the end of 2025, 318 million people received coverage from US health insurers, according to statutory filings required to be made by the plans. That is the bulk of the population and most of those people don’t need the expensive health insurance that covers them. A reminder that 50% of the population incurs $500 or less in health spending annually. There is a better way to deal with unanticipated expensive episodes or chronically high cost patients than making everyone have health insurance, with 15% to 20% of the premiums going to administrative costs or profits and creating a system which incents providers to drive prices up. (MFA Report)
The number of people covered was down by 2.3 million from December 31, 2024. Most of those are likely illegal immigrants. More people may have lost coverage at the start of 2026, but many of these were on the individual exchanges and decided to drop coverage voluntarily. We have all read the stories of retired people not eligible for Medicare with household incomes well over $100,000 whining about how much their health insurance costs. I worry about the single mom with kids who is working multiple jobs and barely getting by. In any event, it is a relatively low percent of people who lost coverage.
Medicare Advantage plans (about 1 million) and employer self-funded plans (about 1.5 million) gained members. Employer risk-based plans (about 1.4 million, many of whom were federal employees), individual plans (around 500,000) and Medicaid (about 2.9 million) lost members. The Medicaid losses are a good thing, again largely illegal immigrants, but also people being told you have to work to get Medicaid and when they get a job they have coverage from work in most cases. Medicaid is covering a fourth of the people with insurance; that is absurdly expensive and is destroying state and the federal budgets. Most of these people can work, many don’t want to, many fake mental illness to avoid work and get Medicaid or Medicare coverage. This is a big reason why health care costs are so high.
