Report Says MA Had $5.7B Underwriting Loss in 2024
Credit rating agency AM Best says that Medicare Advantage (MA) plans had a collective underwriting loss of $5.7B in 2024. From 2019 to 2022, MA made up 40% of underwriting gains and dropped to 20% in 2023. The agency said the losses came from the v28 risk adjustment model (being phased in from 2024 to 2026), lower Star ratings bonus revenue, and high utilization, inflation, and medical costs. About 3 out of 4 insurers with an MA concentration had a loss last year.
#medicareadvantage #margins
ACA Rebates Announced
Insurers are announcing the rebates they will pay back to enrollees and employers because medical loss ratios did not meet the minimum requirement of 80% or 85% as dictated by the Affordable Care Act (ACA). UnitedHealthcare announced it needs to pay out $359 million in rebates for 2024. Centene will pay out about $88 million. Total rebates across the individual, small group, and large group markets are expected to be $1.1 billion.
Additional article: https://www.beckerspayer.com/payer/aca/centene-to-pay-1b-in-aca-rebates-to-missouri-policyholders/
#minimummlr #aca #obamacare
https://www.beckerspayer.com/payer/aca/unitedhealthcare-to-pay-359m-in-rebates
Trump Cancels Sit Down With Democratic Leaders
President Donald Trump cancelled a meeting set with Democratic congressional leaders, saying that nothing productive could come out of the meeting due to Democrats’ demands for healthcare addbacks. A continuing resolution to fund the government for seven weeks died in the Senate when it failed to receive the necessary 60 votes to pass. One Democratic senator voted with Republicans while two Republicans voted with Democrats. Before Trump cancelled the meeting, Speaker Mike Johnson, R-LA, called into question whether a meeting should occur.
Additional article: https://thehill.com/homenews/house/5517347-johnson-trump-schumer-jeffries-meeting-shutdown/?tbref=hp
#governmentshutdown #cr #healthcare #ffy2026
— Marc S. Ryan
