Increasing Medicare Enrollment Continues to Reduce the Commercially Insured Population
The U.S. birth rate has been declining for over a decade (-15.1% from 2007 to 2022. The birth rate rebounded slightly in 2021 but fell again in 2022, signaling a return to previously observed trends where the number of births is not offsetting those aging into Medicare.
Number of U.S. Births Does Not Offset Those Aging Into Medicare
The U.S. birth rate has been declining for over a decade (-15.1% from 2007 to 2022. The birth rate rebounded slightly in 2021 but fell again in 2022, signaling a return to previously observed trends where the number of births is not offsetting those aging into Medicare.
Medicaid Redeterminations Will Result in Coverage Churn
The magnitude of disenrolled Medicaid lives ranges from 318 (Wyoming) to 616.6K (Texas). The extent to which the disenrolled become uninsured or gain marketplace or employer-sponsored coverage will affect the payer mix of almost every healthcare provider and access to healthcare services for millions of Americans.
But the Number of Commercially Insured Americans Continues To Steadily Decline
Commercially insured Americans account for most of the profitable revenue across the health economy. However, the share of commercially insured Americans — including employer-sponsored, Marketplace, direct-purchase and TRICARE — dropped 0.3 percentage points from 2021 to 2022.
Most Americans Have Commercial Insurance
After 2018, the uninsured rate trended down to 7.7% as of early 2023.
When Given the Choice, Fewer Consumers Choose Telehealth
The 45.8% decline in telehealth visit volumes from a peak in Q2 2020 to Q4 2022 reflects how the expanded availability of virtual care options has not shifted widespread consumer preference. Tapering demand suggests that continued telehealth use is concentrated to niche, discrete applications and consumer segments.
Consumer Choice in Public Programs Is Also Evident As Beneficiaries Increasingly Switch To Medicare Advantage
While total Medicare enrollment is projected to grow 21.7% by 2033, MA is expected to account for 61.6% of enrollment. Switching from Traditional Medicare to MA is increasing over time, with the highest increase observed in 2021. In 2021, the switching rate from Traditional Medicare to MA (7.8% percent) was 6.5X higher than the switching rate from MA to Traditional Medicare (1.2%).
Public Dissatisfaction with the Healthcare System Is Growing
Americans are increasingly discontented with the healthcare system. For the first time in 20 years, most Americans (52%) believe the overall healthcare system is substandard, and fewer Americans each year are rating the quality of their own care experiences as high.