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Total health insurance enrollment in the United States declined by 2.3 million members, falling from approximately 320 million in the fourth quarter of 2024 to 318 million in the fourth quarter of 2025.

The data was drawn from the Mark Farrah Associates (MFA) Health Coverage Portal database, which compiles information from sources including the National Association of Insurance Commissioners (NAIC), the California Department of Managed Health Care (DMHC), the Centers for Medicare & Medicaid Services (CMS), and various state agencies.

The overall decline was driven by membership losses across the individual market, employer-group, and Medicaid segments. These declines . . .

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