June 2, 2025
Health insurance companies in 2024 provided fully insured coverage for approximately 186.5 million people, an increase of over 12.3 million from 2020. Blue Cross Blue Shield (BCBS) association members, parent organizations, and their subsidiaries insured about 37.5% of the total health insurance market. In this brief, Mark Farrah Associates (MFA) examined health insurance enrollment changes for the Individual, Group, Medicare and Medicaid segments for BCBS and non-BCBS companies between 2020 (4Q20) and 2024 (4Q24).
Overview
Fully insured health enrollment for non-BCBS reporting plans increased from 122.5 million covered lives in 2020 to 129.0 million in 2021. Enrollment continued to grow to 135.4 million in 2022, but then fell to 132.3 million in 2023, and continued declining to approximately 131.4 million for 2024.
Blue Cross Blue Shield plans reported total enrollment gains from 2020 to 2022, with enrollment increasing from 51.7 million, to over 56.7 million. However, enrollment decreased slightly between 2022 and 2023 from 56.7 million to 55.9 million and then again to 55.2 in 2024. Combined BCBS and non-BCBS reporting plans showed a membership gain of roughly 7%, or 12.3 million for the five year period from 2020 to 2024.
Enrollment By Segment
About the Data
The data used in this analysis was obtained from Mark Farrah Associates' Health Coverage Portal™ database. Findings reflect enrollment reported by carriers with business in the U.S. and U.S. territories. Data sources include the National Association of Insurance Commissioners (NAIC) and the California Department of Managed Health Care (CA DMHC) statutory filings.
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 (www.markfarrah.com), or call 724-338-4100.
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