Health Plan Weekly

Despite reporting fourth-quarter earnings on Feb. 4 that exceeded Wall Street’s projections, Centene Corp. saw its stock price decline by nearly 6%, which analysts attributed to potential concerns about the insurer’s Medicaid and Affordable Care Act exchange segments.  

Centene in the fourth quarter had adjusted earnings per share (EPS) of 80 cents, significantly above the Wall Street consensus estimate of 49 cents, and $40.8 billion of revenue, higher than the $39.1 billion consensus. And its 89.6% medical loss ratio (MLR) was slightly below (better than) the 90% consensus. 

The Cigna Group recently announced it is working to streamline its prior authorization (PA) processes. Experts tell AIS Health that while PA improvements are sorely needed, the move appears to mostly be aimed at quelling public outcry about health insurers that followed the December shooting death of UnitedHealthcare CEO Brian Thompson. 

“You could not even pretend that you’re responding to the firestorm that the Brian Thompson murder opened up if you weren’t addressing prior authorization,” Michael Abrams, managing partner at consulting firm Numerof & Associates, tells AIS Health, a division of MMIT. “That was one of the key sore points for people across the country.” 

While 2024 was an especially challenging year for health insurers, a major credit-rating firm is now predicting that 2025 and beyond may not be that much better.  

Specifically, Moody’s Ratings said in a newly issued report that it is changing its outlook on the health insurance sector from stable to negative.  

The company noted that although major insurers’ earnings growth is likely to remain in the low single digits, “insurers will continue to grapple with medical costs in excess of reimbursement rates” for both Medicare Advantage and Medicaid, “while commercial coverage also faces continued high medical costs.” Moody’s cited projections in PwC’s 2025 Medical Cost Trend Report, which estimated that commercial group medical cost trend in 2025 will be at its highest level in 13 years.  

Amid the chaos of a federal freeze on grant and loan payments issued by Donald Trump’s administration at the end of January, some managed Medicaid plans had to turn to pandemic-era funding mechanisms to ensure their contracted providers could continue operating, a trade organization tells AIS Health, a division of MMIT. And one prominent managed care plan decried the funding freeze as “reckless,” while Energy and Commerce Committee Democrats demanded answers from several federal agencies on the shutdown. 

On Jan. 27, the Office of Management and Budget announced a freeze on all federal grant and loan payments, which prompted immediate legal challenges. Although the White House noted that Medicaid and the Supplemental Nutrition Assistance Program would “continue without pause,” Medicaid payment portals were inaccessible for a time in all 50 states. The portals have since come back online and the freeze was blocked by two federal judges prior to its Jan. 28 effective date. But at least one state’s portal then went down again, causing more frustration. 

Here’s how major health insurers’ stock performed in January 2025. UnitedHealth Group had the highest closing stock price among major commercial insurers as of January 31, 2025, at $542.49. Humana Inc. had the highest closing stock price among major Medicare insurers at $293.23.