Health Plan Weekly

Centene Corp. and Molina Healthcare, Inc., two of the largest managed Medicaid insurers in the U.S., both beat expectations in their third-quarter earnings reports. While the companies saw higher care utilization among their Medicaid members, their medical loss ratios (MLRs) were better than investors anticipated.  

Wells Fargo analyst Stephen Baxter in an Oct. 25 note wrote that Centene’s Medicaid MLR of 93.1% was below the Wall Street consensus of 93.3% and “much better than feared.” Baxter also wrote in an Oct. 24 note that Molina’s Medicaid MLR of 90.5% “was above guidance but by less than feared” following UnitedHealth Group’s and Elevance Health, Inc.’s earnings releases from earlier this month. 

After scuttling merger talks early this year, The Cigna Group is again potentially looking to acquire Humana Inc., according to an Oct. 18 Bloomberg report. The article mentioned the companies have held “informal discussions” about a tie-up but noted “the discussions are in early stages,” citing people familiar with the matter.  

Wall Street analysts, meanwhile, are not surprised the companies have resumed talks. However, they are skeptical a deal could be consummated due to antitrust concerns, especially if Kamala Harris wins the presidential election and current antitrust leadership remains in place. 

With the Medicaid unwinding process winding down, two health insurer trade groups are sounding the alarm about how the resulting changes in the Medicaid risk pool are putting financial stress on nonprofit and regional health plans. To address the situation, both the Alliance of Community Health Plans (ACHP) and Association for Community Affiliated Plans (ACAP) say they want the federal government to push states to raise the payment rates to private Medicaid plans. 

“This is an issue that is impacting much of managed care across the country,” says Jennifer McGuigan Babcock, senior vice president for Medicaid policy at ACAP. “We have heard…anecdotally from our plans that should changes not be made for 2025, and potentially for 2026 rates, there will be significant problems.” 

Only around one-quarter of large employers offer in vitro fertilization (IVF) coverage to employees, according to a recent KFF survey. But a similar survey from the benefits consulting firm WTW revealed that 67% of respondents offer such coverage.  

Despite these dueling outcomes, IVF coverage and other fertility benefits are emerging as a hot topic for employer benefits, experts say. 

KFF’s 2024 Employer Health Benefits Survey revealed that 27% of respondents from companies with 200 or more employees (considered “large employers”) offer IVF coverage, and 30% were unsure of their fertility offerings. It was the first time KFF included the question in the survey, so no data is available on how this has changed over the years.