ELV reported yesterday with a decent enough quarter, I guess, but problems loom. As you would expect, ELV's exposure to Medicaid means they will be subject to losses in the Medicaid membership group as states review eligibility and terminate enrollees. It reported a 6.3% sequential loss of Medicaid membership. Overall, we estimate a 4.3% reduction in Medicaid membership between the end of June and the end of August, the last month for which data are available.
ELV's exposure to California is going to be a factor. Although the state has slow walked redeterminations, the size of its enrollment, about 15.8M, is going to have an effect as it sheds members. None of this is unexpected, of course. What did surprise us was the loss of employer risk-based members and no improvement in employer fee-based. Generally speaking the employer-based market has been performing well recently relative to years of flat to declining enrollment. Here too, geography may matter. California, Illinois and Indiana have been losing population since 2020 and taking with them employers.
It has been a very long time since we thought of the US in regional economic spheres. It might be time to start.
Let me know what you think.
Emily Evans
Managing Director – Health Policy
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