Second Quarter Enrollment Trends; A Segment-By-Segment Comparison
September 24, 2025
Market analysts throughout the health insurance industry rely on enrollment data and segment performance metrics to gain better insights into health plan market share and competitive positioning. Many companies conduct their competitive assessments by using Mark Farrah Associates’ (MFA) Health Coverage Portal™. In this brief, MFA assesses the latest year-over-year enrollment trends, comparing 2nd quarter 2025 with 2nd quarter 2024 segment membership.
Segment Overview
Approximately 320 million people received medical coverage from U.S. health insurers as of June 30, 2025, based on data filed in statutory financial reports from the NAIC (National Association of Insurance Commissioners), the CA DMHC (California Department of Managed Health Care), CMS (Centers for Medicare and Medicaid Services) and various state agencies. This number is down .2% members from June 30, 2024. Year-end enrollment trends indicate membership gains for Medicare Advantage (MA), Employer Group self-funded administrative services only (ASO) business and Individual, while the Medicaid and Employer Group Risk segments continued to experience year-over-year declines.
As of June 30, 2025, market penetration continued to increase for MA business for second quarter, as approximately 1.3 million more seniors chose an MA plan from the previous year. The Individual market for on-and-off exchange business increased membership by over 1.3 million and the Employer-Group ASO (Administrative Services Only) segment gained just over 1.5 million members. In contrast to these enrollment increases, the Employer-Group risk segment, including Federal Employees Health Benefit Plans (FEHBP) business, declined by 1.5 million members and Medicaid experienced a loss of almost 2.1 million members, year-over-year.
Enrollment Trends: Segment by Segment
- Approximately 52% of the 68 million people eligible for Medicare are enrolled in a Medicare Advantage plan, which provides ample opportunities for insurers with MA business. Second quarter 2025 MA enrollment was approximately 34.4 million which was an increased by 1.3 million members, representing 4% growth, from 2Q24.
- Total year-over-year Individual membership for both on-and-off the marketplace exchange increased 5.5% from 25 million members to 26.4 million between 2Q24 and 2Q25. This continues to be due to final Medicaid redeterminations, or people purchasing an individual plan on their own to gain the benefits of subsidized coverage before this option expires at the end of 2025.
- Employer-group, self-funded ASO contracts are a viable option for businesses as they can be more cost effective than risk-based plans. Self-funding is specifically common among larger companies as they can disperse the risk of steep claims over many workers and their dependents. Membership for this segment encompassed 41.6% of total health enrollment for 2Q25. According to MFA’s estimates, Employer-group ASO membership was approximately 133.3 million, an increase of over 1.5 million members, or 1.2%, from 2Q24.
- As of June 30, 2025, 77.1 million beneficiaries received healthcare through Managed Care Organizations (MCOs) and Fee-for-Service type Medicaid programs based on membership filed in statutory financial reports from the NAIC and the CA DMHC, as well as state reported Medicaid and CMS reported Medicaid enrollment reports. This is a 2.1 million member, or 2.6%, decline from the previous year. The decrease in enrollment is primarily due to the conclusion of the public health emergency (PHE) when many state health departments initiated “unwinding” plans of renewals and redetermination.
Note: a portion of CHIP (Children’s Health Insurance Program) enrollment is reported in the Individual segment within statutory reporting.
- Employer-groups have been the leading source of health coverage in the U.S, yet, 2Q25 enrollment figures continued to indicate Employer-group risk membership, including FEHBP members, experienced another decrease between 2Q24 and 2Q25. Membership for the Employer-group risk segment was approximately 48.8 million as of June 30, 2025; a -3% decline from 50.3 million the previous year.
About the Data
The data used in this analysis brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database. Employer group ASO figures may be estimated by Mark Farrah Associates using credible company and industry resources. Individual membership reported by some carriers may include CHIP (Children’s Health Insurance Program). These adjustments may have resulted in moderate understatement or overstatement of enrollment changes by segment. 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), the CA DMHC (California Department of Managed Health Care), CMS (Centers for Medicare and Medicaid Services) and various state agencies. MFA will continue to report on important plan performance and competitive shifts across all segments.
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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