First Quarter 2023 Medicaid Enrollment Snapshot


August 3, 2023



  • As of March 31, 2023 (1Q23), total Medicaid enrollment included nearly 94.2 million Americans, representing a year-over-year (YOY) increase of almost 5.6 million enrollees (6.3%) since the same time last year (1Q22). Enrollment grew by over 881,000 (0.9%) compared to December 31, 2022 (4Q22).
  • With the largest Medicaid enrollment by a significant margin, California accounted for over 750,000 new enrollees, 13.5% of the country’s entire YOY increase. Additionally, California’s quarter-to-quarter contribution covered over 111,000 new enrollees.
  • Other than California, Texas was the only other state to increase YOY by more than half a million Medicaid enrollees, with over 528,000 (a 9.8% increase). Texas was also the only other state to grow by more than one hundred thousand from the previous quarter with 109,000 (a 1.9% increase).
  • Missouri, in terms of percentages, experienced the largest YOY increase with 19.3%, representing just shy of 245,000 covered lives. Missouri also saw the largest quarter-to-quarter increase with 2.7%, or just over 39,000 enrollees.
  • While no states lost any significant membership over the course of the last year due to the public health emergency (PHE), several states saw quarterly drops in Medicaid enrollment. Seven states in total saw enrollment decreases, ranging from 2,500 in Colorado (-0.1%) to almost 27,000 in New Hampshire (-10.6%). These seven states (AZ, CO, AR, KS, ID, NH, SD) account for a combined drop in Medicaid enrollment of approximately 80,000 members. This quarterly change is most likely due to the states’ early adoptions of their PHE unwinding plans, with most states that began renewals and redeterminations on April 1, 2023.

With the public health emergency (PHE) and the federal government’s continuous Medicaid coverage requirement concluded on March 31, 2023, many state health departments have initiated “unwinding” plans of renewals and redetermination. While it is currently unclear how these renewals will impact both Medicaid and private enrollments, evaluating market share in response to these changing laws and redeterminations 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 Private Risk, Private Administrative Services Only (ASO), 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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