Five Year Snapshot of Blue Cross Blue Shield (BCBS) and Non-BCBS Health Enrollment; 2016 - 2020


May 18, 2021


Health insurance companies in 2020 provided coverage for over 295 million people, an increase of over 7 million from 2016.  Mark Farrah Associates (MFA) examined the health insurance enrollment changes between Blue Cross Blue Shield (BCBS) and Non-BCBS companies in that five-year span.

Total health enrollment for non-BCBS reporting plans decreased from 181.1 million in 2016 to 178 million in 2018 before rebounding in 2019 and 2020. Non-BCBS plans reported 182.3 million members, a net gain of over 1 million members since 2016.   Blue Cross Blue Shield plans reported enrollment gains every year from 2016 through 2020 with enrollment of 107.2 million and 113.3 million respectively, an increase of over 6 million in the 5-year span. Combined BCBS and non-BCBS reporting plans showed a gain of nearly 7.2 million members from 2016 through 2020.



Both BCBS and non-BCBS plans experienced decreases for Individual and Group enrollment throughout the 5-year period, while trending upward for Medicare and Medicaid.

BCBS companies experienced a 20.3% total decrease over the last 5 years in Individual enrollment, as well as a drop of 4.8% for Group enrollment. While non-BCBS companies reported an 11.4% drop in Individual enrollment, and a drop of 10.9% in Group enrollment during same period.

For the government programs of Medicare and Medicaid, enrollment for both BCBS and non-BCBS companies increased from 2016 to 2020. Medicare enrollment increased over 911,000 for BCBS companies, representing a 29.8% increase, while non-BCBS enrollment increased by over 6 million, constituting a 39.4% increase. Medicaid enrollment for both BCBS and non-BCBS companies increased over the five-year period.  BCBS reporting plans increased 29.8% with an enrollment increase of approximately 3.2 million members.  Non-BCBS plans added almost 5 million Medicaid members during 2020, however, due to years of declines, enrollment only increased 0.7% with a gain of almost 410,000 over the 5-year period.



About the Data

The data used in this analysis brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database. It is important to note that MFA estimated fourth quarter 2020 enrollment for a small number of late filing health insurance plans in order to better represent market segment size. Findings reflect enrollment reported by carriers with business in the U.S. and U.S. territories. Data sources include NAIC (National Association of Insurance Commissioners) and the CA DMHC (California Department of Managed Health Care).

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.

Healthcare Business Strategy is a FREE monthly brief that presents analysis of important issues and developments affecting healthcare business today. If you would like to be added to our email distribution list, please submit your email address to the "Subscribe to MFA Briefs" section at the bottom of this page.

Request Information

Thank you for your interest. Please send us your email and we will contact you
within 1-2 business days.