Continued Managed Medicaid Enrollment Declines for Top Leaders in 2024

April 30, 2025

• Based on filings from the National Association of Insurance Commissioners (NAIC) and the California Department of Managed Health Care (CA DMHC), Centene continued to lead the Managed Medicaid market with over 12 million members in 4Q24, down by over 1 million, compared to 4Q23, or -8%.
• Elevance’s Medicaid membership experienced a 1.2 million-member decline, or -14.4% from 2023 to 2024.
• UnitedHealth lost approximately 439,000 (-7.5%) members, with total Medicaid enrollment at 5.4 million, for 4Q24.
• Molina saw the smallest percentage drop of the top insurers, falling by 3.6%. 2024 year-end enrollment stood at 4.1 million.
• 4Q24 Medicaid enrollment for Local Initiative Health for LA County stood at nearly 2.4 million, a  171,000 member decline, or -6.7%.

About the Data

The data used in this brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database, including information from the National Association of Insurance Commissioners (NAIC) and the California Department of Managed Health Care (CA DMHC).

Please note: There are differences in reported Medicaid membership between the NAIC and U.S. Securities and Exchange Commission (SEC) filings due to segment definitions, state laws, and other causes. This analysis is focused on the Managed Medicaid market as reported to the NAIC. In 2024 annual SEC 10K reports, Medicaid membership for Centene was 13 million, Elevance reported 8.9 million, UnitedHealth reported approximately 7.4 million, and Molina mentioned nearly 4.9 million. Local Initiative Health for LA County does not file with the SEC.

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™, 5500 Employer Health ^plus, 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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