August 4, 2021
With the economic impact of the COVID-19 Pandemic and provisions in the Families First Coronavirus Response Act (FFCRA), Medicaid enrollment grew substantially from December 2019 to 2020. Total Medicaid and Children’s Health Insurance Program (CHIP) enrollment was over 80 million as of December 2020 according to the Centers for Medicare & Medicaid Services (CMS) Monthly Medicaid & CHIP Application, Eligibility Determination, and Enrollment Reports & Data . This represents an increase of almost 9 million from December 2019.
Medicaid membership available through the National Association of Insurance Commissioners (NAIC) and California Department of Managed Health Care (CA DMHC) statutory sources accounts for approximately 76% of the total Medicaid membership. Beginning in February this year, Mark Farrah Associates (MFA) began an initiative to report the remaining 24% related to state managed Medicaid programs Fee-for-service (FFS) and companies managing Medicaid care with membership that is not reported via the NAIC or CA DMHC. MFA’s Health Coverage Portal™ now represents a complete picture of the Medicaid market. It is important to note that CHIP enrollment reporting, along with the timing of CMS data availability, account for the roughly 800,000 member variance between CMS and MFA figures. The Medicaid Enrollment Source table below contains the breakdown.
Medicaid Enrollment Source - Membership Trend |
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Enrollment Source |
4Q19 |
Market Share |
4Q20 |
Market Share |
Change |
NAIC Reported |
40,622,669 | 58.3% | 47,669,583 | 61.2% | 7,046,914 |
State Reported/FFS |
18,341,517 | 26.3% | 18,516,181 | 23.8% | 174,664 |
CA DMHC Reported |
10,661,307 | 15.3% | 11,651,366 | 15.0% | 990,059 |
Total |
69,625,493 | 100.0% | 77,837,130 | 100.0% | 8,211,637 |
Source: Health Coverage Portal™, Mark Farrah Associates |
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Market Share
The table below shows that the top 10 companies in December 2020 all increased Medicaid enrollment from the same period in 2019. Note that Centene’s growth was mostly due to the January 2020 acquisition of WellCare. Removing the roughly 3.7 million WellCare gained enrollees from Centene in the December 2020 data would leave Anthem with the largest year-over-year increase of 1.4 million. Centene’s addition of WellCare’s Medicaid members is also why the All Others + FFS category is showing a year-over-year loss.
Leading Medicaid Companies - Membership Trend |
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Company |
4Q19 |
Market Share |
4Q20 |
Market Share |
Centene |
6,658,208 | 9.6% | 10,862,199 | 14.0% |
Anthem |
5,822,922 | 8.4% | 7,233,328 | 9.3% |
UnitedHealth |
4,739,641 | 6.8% | 5,403,123 | 6.9% |
Molina |
2,813,780 | 4.0% | 3,615,159 | 4.6% |
Local Initiative Hlth LA Cnty |
2,059,879 | 3.0% | 2,240,648 | 2.9% |
CVS |
1,250,370 | 1.8% | 1,960,275 | 2.5% |
Independence Blue Cross |
1,599,680 | 2.3% | 1,843,226 | 2.4% |
Caresource |
1,516,948 | 2.2% | 1,789,280 | 2.3% |
Fidelis SeniorCare |
1,234,620 | 1.8% | 1,619,854 | 2.1% |
Inland Empire Health Plan |
1,214,113 | 1.7% | 1,326,955 | 1.7% |
Top 10 Companies |
28,910,161 | 41.5% | 37,894,047 | 48.7% |
All Other + FFS |
40,715,332 | 58.5% | 39,943,083 | 51.3% |
Total Medicaid |
69,625,493 | 100.0% | 77,837,130 | 100.0% |
Source: Health Coverage Portal™, Mark Farrah Associates |
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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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