Elevance Health reported a decline in membership during the second quarter, underscoring the challenges faced by major insurers as they seek to raise premium rates on Affordable Care Act (ACA) plans to address increasing government healthcare costs.

As of June 30, Elevance’s medical membership, which counts enrollees across its insurance products, decreased by 469,000 individuals, or 1%, sequentially to 44.9 million. This figure also represented a 1.5% year-over-year decline. The reduction was attributed to shifts among commercial fee-based customers and some attrition within ACA and Medicaid segments.

Breaking down the figures by program, Medicare Advantage membership fell sharply by 16% to 1.9 million, while Medicaid enrollment dropped by 4.3% to 8.4 million members. Despite these declines, the company continues to grapple with rate pressures on its ACA offerings. Premiums for many ACA plans increased by double-digit percentages this year, and insurers, including Elevance, anticipate pursuing comparable hikes in upcoming rate-setting cycles.

Industry experts note that rising medical costs and regulatory factors contribute to insurers’ strategies to adjust premiums, even as membership numbers fluctuate. Elevance’s results reflect the broader tension between maintaining coverage accessibility and managing escalating healthcare expenditures under government programs.