Medicaid, Medicare reflect 59% of revenue for 5 largest commercial insurers

After the ACA's passage, the number of Americans enrolled in public coverage grew faster than the number in private health plans across the five biggest commercial payers, according to a recent study in Health Affairs.

The study — supported by The Commonwealth Fund — examined annual corporate filings with the Securities and Exchange Commission of the five largest for-profit commercial insurers: UnitedHealthcare, Anthem, Aetna, Cigna and Humana. The 2010-16 data span three years prior to the ACA's significant insurance reforms and three years after.

Here are four findings from the study.

1. Medicaid and Medicare represented 59 percent of revenue for the five largest payers in 2016, or $213.1 billion. That's more than double the $92.5 billion in revenue the five payers attributed to public programs in 2010.

2. From 2010 to 2016, the five payers saw Medicaid and Medicare enrollment double to 25.5 million. Medicaid grew from 7 million in 2010 to 15 million in 2016, with the five insurers participating in 31 state Medicaid programs.

3. The top five commercial payers cover 125 million people, or 43 percent of the nation's insured population. Membership among the five companies increased by 23 million between 2010 and 2016.

4. "These findings are an important reminder that despite reporting losses in the Affordable Care Act marketplaces, the nation's biggest insurance companies generated substantial revenues thanks to Medicare and Medicaid," said Commonwealth Fund President David Blumenthal, MD. "This growing dependence on taxpayer-funded insurance programs suggests there are opportunities to improve access to healthcare and stabilize insurance markets if insurers that participate in these programs also offer plans in the ACA marketplaces."

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