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Expand chart
Data: Company filings, CMS, Kaiser Family Foundation; Chart: Michelle McGhee/Axios

National Medicaid enrollment hit a record 80.5 million this past January, as Congress provided extra funding for states to retain and sign up more low-income adults and children during the coronavirus pandemic.

Between the lines: Because more states have outsourced their Medicaid programs to private health insurers, this pandemic-fueled growth also has been a boon for some of the largest insurance companies.

State of play: Health insurers have been pursuing more revenue from government health programs, including Medicaid.

  • Seven out of 10 Medicaid enrollees are in a plan run by an insurance company, according to the Kaiser Family Foundation.
  • That would mean roughly 55.5 million of the 80.5 million people now on Medicaid are in a privately run plan.
  • And of those 55.5 million, roughly two-thirds are in a plan owned by five dominant insurance companies.
  • Centene covers 13.6 million Medicaid enrollees, the most of any company. Centene acquired WellCare last year and is now so large, it essentially functions as a branch of state and federal governments.

Worth noting: "The evidence is thin that these contractors improve patient care or save government money," Chad Terhune reported for Kaiser Health News in 2018.

Go deeper: Medicaid will be a coronavirus lifeline

Go deeper

Biden's reengineer-America moment

Illustration: Sarah Grillo/Axios

The Senate's bipartisan $1.2 trillion infrastructure bill and President Biden's $3.5 trillion spending package could live or die this week — and take Democrats' fortunes with them. But all the minute-by-minute political drama obscures how much America could change if even a fraction of it passes.

The big picture: Anything short of total failure could have a transformative impact on day-to-day life — from how we move around to our access to the internet, paid family leave and child care, health care and college.

Biden says he'll make Supreme Court pick by end of February

President Biden speaks on the retirement of Supreme Court Justice Stephen Breyer in the Roosevelt Room of the White House. Photo: Yuri Gripas/Abaca/Bloomberg via Getty Images

President Biden on Thursday said he will announce the nominee for Supreme Court Justice Stephen Breyer's replacement by the end of February.

Driving the news: Biden also affirmed that he will nominate a Black woman to replace Breyer, saying "it's long overdue."

Stephen Breyer formally announces retirement from Supreme Court

Photo: Andrew Harnik/AP

Justice Stephen Breyer on Thursday sent a letter to President Biden formally announcing his retirement from the Supreme Court.

State of play: Breyer said his retirement will take effect when the court "rises for the summer recess (typically late June or early July) assuming that by then my successor has been nominated and confirmed."