Public health programs continued to increase their share of U.S. enrollees in the first quarter, a tracking firm says. 

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Analysts at Mark Farrah Associates say enrollment in managed Medicaid plans increased to 49 million in the quarter. That was up 9 percent from the total for the first quarter of 2015.

States hire private companies to run managed Medicaid plans. Indianapolis-based Anthem and four other carriers serve about 40 percent of the managed Medicaid enrollees, the analysts say. 

Related: Medicaid market player list holds steady

Mark Farrah analysts are also reporting that:

  • Enrollment in Medicare Advantage plans rose 5.2 percent, to 18.2 million.

  • Enrollment in fully insured group plans fell 0.8 percent, to 60 million, and enrollment in self-insured group plans rose 1.6 percent, to 118 million.

  • The number of people with individual or family coverage they bought themselves rose just 1 percent, to 20.5 million, after increasing 37 percent between the first quarter of 2014 and the first quarter of 2015.

The analysts base their figures on public filings and other sources.

The enrollment change figures in the group health market are similar to what they have been for more than a decade, since before the Affordable Care Act took effect, according to Mark Farrah analysts.

The numbers for self-insured health plans support “accounts of growth in self-funded employer groups in recent years, due in part to employer exemptions from many of the ACA’s benefit mandates and requirements,” the analysts write.

Managers of Covered California, a state-based ACA public exchange that serves about 1.4 million individual health enrollees, noted in June that the exchange must attract 700,000 to 900,000 new enrollees per year just to hold usage steady, in part because it loses many enrollees each year to Medicaid, Medicare and employer group plans. 

Related: Medicare Advantage issuers gain market share

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