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More 2024 Insurance Financial Results A number of additional health plans announced financial results for 2025. Clover Health’s stock dipped Feb. 28 after the company announced an earnings per share loss and a 2% miss on quarterly revenue. But the company reported a full-year 2024 adjusted EBITDA of $70 million, a huge year-over-year increase of $112 million. Alignment Healthcare achieved its first year of positive adjusted EBITDA as a company. It also reported a huge surge in enrollment. Blue Cross Blue Shield of Massachusetts reported a $400 million operating loss in 2024, driven by spending on GLP-1 medications and other rising medical costs. The company posted a -4.3% operating margin in 2024, compared to a 0.4% margin in 2023.  In other news, Becker’s reports on Blues’ MA enrollment as well as insurers who gained and lost membership for 2025 in MA. Additional articles: https://www.fiercehealthcare.com/payers/clover-health-nets-70-million-adjusted-ebitda-misses-revenue-goals and https://www.fiercehealthcare.com/payers/alignment-healthcare-posts-701-million-quarterly-revenue-beats-expectations and https://www.beckerspayer.com/payer/bcbs-massachusetts-reports-400m-loss-driven-by-glp-1-spending.html and https://www.beckerspayer.com/payer/bcbs-plans-ranked-by-medicare-advantage-members-2025.html #healthplans

Another Study Shows Impact Of Medicaid Reimbursement Cuts To States A second study finds the major impact of reducing federal dollars for Medicaid to states. States that expanded Medicaid coverage could have to find $44.3 billion annually in state budget cuts or increased revenue to maintain what they have. The Urban Institute and Robert Wood Johnson Foundation (RWJF) say state spending would be hiked by about 25.6% on average if that occurred. Twelve states have trigger laws that would drop the expansion if the enhanced reimbursement is halted. I told you yesterday about a Kaiser Family Foundation (KFF) analysis of the spending reductions related to a Medicaid per capita cap program. KFF finds that capping per enrollee spending could reduce federal Medicaid expenditures by $532 billion to nearly $1 trillion over 10 years depending on how states respond. KFF also finds that eliminating the Medicaid expansion matching rate as well

MA Growth Down Markedly In Enrollment Season The Centers for Medicare and Medicaid Services (CMS) finally published some data on the 2025 enrollment season and growth is down considerably. This is likely tied to the financial crisis in the industry. The January report still seems to have issues so many analysts are either comparing February 2024 to February 2025, January 2024 to February 2025, or a month in late 2024 to February 2025. I will have a comprehensive blog on this subject tomorrow. Different outlets have ranges of numbers in their coverage. My calculation is that enrollment grew about 4.4% from January 2024 to February 2025. This is down from 8.7% in 2024 and 6.1% in 2022. Of the big nine national health plans, seven gained enrollment from January 2024 to February 2025. But just five of them gained from December 2024 to February 2025. In other news, the Kaiser

House Passes Budget Framework; Healthcare Cuts Heat Up The House adopted a budget reconciliation bill today with just one GOP defection. House Speaker Mike Johnson and President Donald Trump got three other doubters to convert to “yes.” The vote was 217 to 215. The bill paves the way for final passage down the road but a great deal of work has to occur, with committees now meeting on spending cut targets. This includes $880 billion in healthcare spending cut targets. Johnson and perhaps Trump convinced holdouts that Medicaid rolls will not be cut except for work requirements and if someone is illegally on the program. It may be hard to keep the commitment with a large reduction bogey. The victory was major for Johnson but he now needs to hold all these folks in place as spending cuts are debated in committees. Meanwhile, healthcare news is heating up due to the

More Surprises From Trump On Drug Pricing Donald Trump’s Centers for Medicare and Medicaid Services (CMS) in late January said it would continue Medicare drug price negotiations. Then, in a Super Bowl interview, Trump bemoaned the cost of GLP-1 weight-loss drugs in America compared with other developed nations. Now, the Trump administration has chosen to defend the Medicare drug price reform law in court. In a filing Feb. 19, the government agreed with the legal arguments used by the Biden administration and by a lower court. Trump so far is not what Big Pharma hoped. #ira #medicare #partd #drugpricing #branddrugmakers https://www.fiercehealthcare.com/payers/trump-admin-defends-ira-drug-price-negotiation-program-novartis-lawsuit FDA Workers May Be Headed Back To Work Fired Food and Drug Administration (FDA) probationary workers are receiving calls that their terminations are being rescinded. The Department of Government Efficiency (DOGE) commission clearly jumped the gun on firing all probationary positions throughout government. #doge #layoffs #trump #spending https://www.fiercehealthcare.com/regulatory/mass-layoffs-hhs-cdc-cuts-1300-probationary-workers-reports-say United Comes

Centene and Molina Could Be Hurt By Medicaid Cuts Medicaid managed care-dominant insurers Centene and Molina could be hurt by Republicans’ plans for cuts to Medicaid. The House GOP has a target of $800 billion in healthcare spending reductions. While President Trump and GOP leaders have promised no dramatic changes to Medicaid, the targets would clearly mean deep reductions. While work requirements and fraud cuts are certain, other impacts could be reimbursement changes at the state level. Centene is the largest Medicaid managed care insurer with 13 million Medicaid beneficiaries as of Dec. 31. The membership generates 62% of the company’s revenue. Medicaid represents 88% of Molina’s membership and nearly 80% of its revenue for 2024. (Article may require a subscription.) #medicaid #managedcare #budgetreconciliation #trump #congress #molina #centene https://www.modernhealthcare.com/insurance/medicaid-cuts-centene-molina-healthcare WSJ Says DOJ Probing United The Wall Street Journal reports that the Department of Justice (DOJ) is probing UnitedHealth Group’s billing