The 2024 Cliff
Spending dropped 76% in 2024. Ten million people disenrolled. Is it a collapse or a reset? Understanding who got left behind tells us everything.
Thursday, February 12, 2026|~11 min
“It's not a collapse. It's a reset. And understanding who got left behind tells us everything.”
Key Findings
- 76% spending drop driven by enrollment, not system failure
- ~10M people disenrolled (Sept 2023 – Dec 2024)
- Personal care disproportionately affected
Data Points
$17.8B (Jan 2024) to $4.2B (Dec 2024)
Per-claim costs remained stable
Remaining beneficiaries: older, more complex cases