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Quarterly Shifts in Managed Medicaid Enrollment as States’ Pandemic Protections End


September 13, 2023



  • By the end of 2Q23 (June 30, 2023), total managed Medicaid enrollment across the country was just over 78 million members, representing a decrease of nearly 793,000 covered lives from the end of 1Q23 (March 31, 2023). With staggered redeterminations and unwinding of pandemic protection programs going into effect throughout 2Q23, these membership drops were not unexpected for Managed Care Organizations (MCOs) across the country.
  • For select states, the first wave of redetermination was slated to begin on April 1, 2023. Among these initial states, Arizona has since seen a quarterly decrease of over 173,000 members (8.2%). New Hampshire was also among the earliest of these “unwinding” states, and saw a significant 21.3% drop in quarterly enrollment, accounting for roughly 53,000 covered lives.
  • Of the states scheduled to begin redeterminations on May 1, Florida experienced the single largest exodus of membership during the quarter, losing over 370,000 members, or about 8%. Utah and West Virginia both dropped just over 43,000 members; however, that accounted for 13.4% of Utah’s Medicaid enrollment and only 7.9% for West Virginia.
  • For many states, June 1, 2023 was the starting point for redeterminations within the 2Q23 reporting period. By the end of the quarter, Texas dropped over 310,000 covered lives, representing about 5.6% of Medicaid enrollment in the state. South Carolina experienced an 8% decrease (87,900 members) and Colorado lost 2.6% (37,400).
  • For the second quarter, notable exceptions to these trends are California and Massachusetts. While California saw a growth of 272,000 (1.8%), Massachusetts expanded by over 238,000 (27.8%). Two Massachusetts plans, Boston Medical Center Health Plan and Mass General Brigham Health Plan, saw significant jumps of 320,000 (112.1%) and 121,000 (276.1%), respectively; these increases are attributable to a new MassHealth contract that began on April 1, 2023. Massachusetts was among the states set to initiate its redetermination on June 1, reflected in the enrollment for Fallon, down by over 16,000 members (12.9%), and Point32Health, which lost over 190,000 (55.5%).

As state health and human services departments unwind and return to regular operations, Mark Farrah Associates will continue to monitor enrollment across the country, using Health Coverage Portal™.

About the Data

The data used in this brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database, including information from the National Association of Insurance Commissioners (NAIC), the California Department of Managed Health Care (CA DMHC), and other reliable sources. It is important to note that MFA estimated enrollment figures for select health plans to facilitate accurate enrollment among multi-state plans.

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, Medicare Business Online™, Medicare Benefits Analyzer™, 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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