What follows are highlights of the firm's findings, based on financial insights gleaned from aggregated 2024 and 2025 National Association of Insurance Commissioners (NAIC) statutory financial data from MFA's Health Coverage Portal™.

Enrollment in Individual medical plans as of December 2025 totaled approximately 25 million, compared to 25.4 million at the end of 2024. The 1.5% decline marks the first decrease in enrollment since 2019 for the segment, according to MFA. Premiums increased 6.6% in 2025, while medical expenses incurred climbed 16.5% since 2024.
Health insurance companies in the Employer-Group risk segment reported approximately 41.4 million members, as of December 31, 2025, down 4.2% from 2024. For health insurers with Employer-Group business, profitability decreased in 2025, while premiums earned increased 1.7%, and medical expenses increased 3.7% compared to 2024.
The Medicare Advantage (MA) segment continues to rapidly grow, with total enrollment of approximately 35.7 million in 2025 — an increase of more than 1.1 million members since 2024. Year-over-year profitability for this segment, like the Group segment, decreased. On the other hand, premiums earned increased 16.1% in 2025, while medical expenses increased 18% from 2024.
December 2025 Medicaid and CHIP membership was down 2.9 million from the previous year to 76.2 million members. For 2025, premiums earned increased 9.4% while medical expenses incurred increased 8.9% from 2024.

Instant Insights /

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