UNH (US)

Through 2028, Obamacare enrollment faces two statutory headwinds after the large, still unfolding 2026 reset: The 2027 narrowing of ACA subsidy eligibility for certain non-citizens. The 2028 installation of pre-enrollment subsidy eligibility verification. For exchange…

Tuesday’s CMS release detailing the financial components of its CY27 standalone Medicare Part D program and its decision to sunset the related two-year Part D Premium Stabilization Demo suggest additional uncertainty for standalone Part D…

Home health (HH) agencies [PNTG, BTSG, AVAH, UNH, ADUS, Elara] received a favorable surprise in CMS’s proposed CY27 Medicare HH reimbursement rule, released Wednesday. The regulation includes: A temporary 3% recoupment adjustment, matching the final…

Senate HELP Chairman Bill Cassidy’s (R-LA) recently introduced 340B Drug Pricing Integrity and Affordability for Patients Act raises threats to 340B contract pharmacies (both brick-and-mortar and mail-order) [CVS and private Walgreens, and to a much…

CMS informed Medicare Advantage (MA) insurers [HUM, UNH, CVS, ELV, CNC, ALHC, MOH, CLOV] that it is voluntarily recalculating their CY26 Star Ratings, which determine CY27 Quality Bonus Payments (QBP). Under the agency’s approach, released…

While Medicaid and ACA enrollment concerns have dominated the policy overhang for hospitals this year, Medicare-related risks could move higher on investors’ radar with the release of CY27 hospital outpatient prospective payment system (OPPS) proposed…

Last week’s federal court ruling in favor Clover Health (CLOV) against CMS injects fresh uncertainty into the Medicare Advantage (MA) Star Ratings and quality bonus payment framework [UNH, HUM, ELV, CVS, ALHC, CNC, MOH]. While…

UNH’s new Optum Rx model, which shifts PBM and group purchasing organization compensation in its commercial business toward transparent flat fees, appears designed to modestly outpace similar transparency initiatives from CI and CVS while aligning…

With 1Q26 earnings now largely complete for the major Medicare Advantage (MA) insurers [UNH, HUM, ALHC, CVS, ELV, CNC, MOH], near-term MA policy risks remain less acute, though far from extinguished. Congressional cuts remain unlikely…

A wave of state actions (AR, IA, ID, IN, MO, MT, NC, NE, NH) on Medicaid community engagement requirements (aka work requirements), spanning both accelerated implementation like today’s launch in NE and in some cases,…