Managed Medicaid Enrollment Continues Decline for Top Leaders in 2025

June 24, 2026

• 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 11.6 million members by year’s end 2025 (4Q25), down by more than 3.2 million compared to 4Q22, or -21.7%.
• Elevance’s Medicaid membership experienced a decline of 2.8 million members, or -30.6%, from 4Q22 to 4Q25, ending the period with 6.4 million covered lives.
• For the same period, UnitedHealth lost approximately 1.3 million enrollees (-20%), with total Medicaid enrollment settling at 5.2 million for 4Q25.
• Molina saw a decrease of -15.6%, representing a loss of 706,000 covered lives over the five-year period, ending 4Q25 with 3.8 million enrollees.
• 4Q25 Medicaid enrollment for Local Initiative Health Authority for LA County stood at nearly 2.3 million, a 329,000-member decline since 4Q22, a -12.6% drop in covered lives.

About the Data

The data used in this brief was obtained from Mark Farrah Associates' County Health Coverage™ 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 focuses on the Managed Medicaid market as reported to the NAIC. In 2025 annual SEC 10K reports, Medicaid membership for Centene was 12.5 million, Elevance reported 8.5 million, UnitedHealth reported approximately 7.4 million, and Molina indicated nearly 4.6 million. The Health Authority 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, ASO Employer Health ^plus, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™. For more information about these products, refer to the product pages and brochures available under the Our Products section of the website (www.markfarrah.com) or call 724-338-4100.

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