UnitedHealth's headquarters in Minnetonka, Minnesota. Credit: UnitedHealth
UnitedHealth is planning to let Medicare Advantage plan enrollment fall about 1 million, or 12%, in 2026, because of concerns about the effects of enrollee claim costs and federal subsidy cost-cutting efforts.
The Minnetonka, Minnesota-based company expects to lose about 600,000 enrollees due to decisions to leave some markets, according to Bobby Hunter, the CEO of UnitedHealth's government programs unit and the head of its Medicare insurance business.
The company expects to lose another 200,000 Medicare Advantage enrollees due to price increases in the group Medicare Advantage plans sold to employers that offer retiree health benefits, and 200,000 due to price increases, benefits cuts and other changes for the individual products still on the shelves, Hunter said.
"I absolutely believe in the long-term growth potential of MA," Hunter said. "Right now, though, medical trend pressure is increasing the cost of health care, and the funding cuts of the program are degrading choice, access and value to the consumer."
Hunter and other UnitedHealth executives talked about the Medicare Advantage program Tuesday, during a conference call that the company held to go over results for the third quarter.
Executives also noted that, because of high health care costs, rule changes and subsidy cuts and uncertainty at the Affordable Care Act public exchange plan program, the company expects to let enrollment in that program fall by about two-thirds in 2026.
UnitedHealth streamed the call live online and has posted a recording on its website.
What it means: Anyone advising retirees or near-retirees about anything related to insurance, risk management or financial services needs to have something intelligent to say about the turmoil in the Medicare plan market.
The backdrop: Medicare Advantage is a program that gives private companies a chance to provide what looks to the 69 million Medicare enrollees like a replacement for "original Medicare" coverage.
The private plans — which help fill in the many gaps in original Medicare coverage — serve 35 million people. UnitedHealth plans have a 24% share of the Medicare Advantage plan market.
The future: Tim Noel, CEO of the UnitedHealthcare businesses, another UnitedHealth unit, said that Trump administration officials seem to be receptive to hearing ways to improve the Medicare Advantage program.
"This is in direct contrast to what we experienced over the previous administration," Noel said.
The earnings: The third quarter ended Sept. 30.
UnitedHealth reported $2.5 billion in net income for the quarter on $113 billion in revenue, compared with $6.1 billion in net income on $101 billion in revenue for the third quarter of 2024.
The company ended the quarter providing or administering health coverage for 20.2 million people, up from 19.6 million people a year earlier.
The company's enrollment in Medicare Advantage plans increased to 8.4 million, from 7.8 million a year earlier.
The number of users of another type of plan that fills in Original Medicare coverage holes, Medicare supplement insurance, held steady at about 4.3 million.
Affordable Care Act exchange plan enrollment was not reported separately.
UnitedHealth's headquarters in Minnetonka, Minnesota. Credit: UnitedHealth
© Touchpoint Markets, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.