JAMA Network March 30, 2023
Medicare and Medicaid, the government’s primary health insurance programs, together cover over 40% of the US population. We typically differentiate the “public” coverage that the government finances through these programs from the “private” commercial insurance coverage paid for by employers and individuals.
Yet increasingly, our public insurance programs are looking very private. As of 2022, nearly half (48%) of Medicare beneficiaries were enrolled in Medicare Advantage plans operated by private insurers, up from about one-quarter a decade ago, with the other half in traditional Medicare.1 UnitedHealthcare and Humana account for almost half of all Medicare Advantage enrollment.
In Medicaid, 72% of beneficiaries were enrolled in managed care plans as of 2020, with 5 insurance companies—UnitedHealthcare, Centene, Anthem (renamed “Elevance Health”...
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