Health Insurers Performing Better But There’s Potential Trouble Ahead

InnovationHealthcareHealth Insurers Performing Better But There’s Potential Trouble AheadByBruce Japsen,Senior Contributor.Forbes contributors publish independent expert analyses and insights. Bruce Japsen writes about healthcare business and policy.Follow AuthorMay 10, 2026, 08:00am EDTClose up of a medical insurance form with stethoscopegettyHealth insurance companies including UnitedHealthcare, CVS Health’s Aetna, Centene and Blue Cross and Blue Shield plans owned by Elevance Health are seeing lower costs from patients submitting claims.But there’s trouble ahead for plans offering government-subsidized health insurance as Americans drop coverage or can no longer afford it due in part to healthcare policy changes by the Republican Congress and Donald Trump White House.Take the nation’s largest health insurer, UnitedHealthcare, owned by UnitedHealth Group, which last month reported a medical loss ratio, which is the percentage of premium revenue that goes toward medical costs, below 85% for the first quarter of this year. And Wall Street was thrilled and the company’s stock jumped. Most health insurers have been battling rising medical expenses from customers in their health plans for the better part of the last two years. Their medical loss ratios, also called benefit expense or medical care ratios, have been around 90% or higher in most cases. Last year, UnitedHealthcare’s full year adjusted 2025 medical care ratio was 88.9% compared to 85.5% in 2024. And its adjusted medical care ratio was more than 91% in the fourth quarter.But UnitedHealth’s "first quarter 2026 medical care ratio was 83.9% compared to 84.8% in the first quarter 2025,” the company said. “The year-over-year decrease was driven by strong medical cost management and favorable reserve development, partially offset by consistently elevated utilization and unit cost trends.”MORE FOR YOUStill, industry analysts say costs could rise again and threaten insurer cost management. "Sector developm...