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So far in 2025, ACA Marketplace enrollment has more than tripled since 2020 in at least 6 states: Texas, Mississippi, Georgia, Louisiana, West Virginia, and Tennessee. All of these states were won by President Trump.
In 2024, ACA enrollment (including Marketplace, Medicaid expansion, and BHP) reached 44 million, or 16.4% of the nonelderly U.S. population. From 2020-2024, enrollment in ACA coverage increased by over 60%.
A new KFF analysis finds that there were 44 million people enrolled in health coverage through the Affordable Care Act’s Marketplaces and its expansion of the Medicaid program in 2024. That represents about 1 in every 6 people under age 65, or 16.4%.
This brief takes a closer look at the five largest publicly traded companies operating Medicaid MCOs which account for half of Medicaid MCO enrollment nationally. Information and data reported in this brief come from quarterly company earnings reports, financial filings, and other company materials as well as from national administrative data.
Between 8 and 24 million people across the U.S. could be disenrolled from Medicaid during the unwinding of the program’s continuous enrollment provision. KFF's new analysis offers three illustrative scenarios for how state-level Medicaid enrollment could decline between March 2023 and May 2024, ranging from 8 percent to 28 percent of total enrollees.
This brief describes 10 key points about the unwinding of the Medicaid continuous enrollment requirement, highlighting data and analyses that can inform the unwinding process as well as recent legislation and guidance issued by the Centers for Medicare and Medicaid Services (CMS) to help states prepare for the end of the continuous enrollment provision.
This analysis estimates Medicaid enrollment growth by state and eligibility group between February 2020, before the pandemic, and March 31, 2023, at the end of the continuous eligibility period. These estimates can help paint a picture of the overall number and composition of enrollees who may risk coverage loss after the continuous enrollment provision ends.
In 2024, more than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans. This brief provides current information about Medicare Advantage enrollment, by plan type and firm, and shows how enrollment varies by state and county.
The unwinding of pandemic enrollment protections in Medicaid helped accelerate states’ expansion of eligibility for key groups and adoption of policy and system changes to streamline renewal processes for enrollees, according to findings from a new KFF survey of state Medicaid officials.
The 22nd annual survey of state Medicaid and CHIP programs officials conducted by KFF and the Georgetown University Center for Children and Families in May 2024 presents a snapshot of actions states have taken to improve systems, processes, and communications during the unwinding, as well as key state Medicaid eligibility, enrollment, and renewals policies and procedures in place as of May 2024. The report focuses on policies for children, pregnant individuals, parents, and other non-elderly adults whose eligibility is based on Modified Adjusted Gross Income (MAGI) financial eligibility rules.
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