Health Plan Weekly

Here’s how major health insurers’ stock performed in February 2024. Elevance Health, Inc. had the highest closing stock price among major commercial insurers as of Feb. 29, 2024, at $501.25. Humana Inc. had the highest closing stock price among major Medicare insurers at $350.32.

President Joe Biden’s health care agenda figured prominently in his State of the Union address on March 7. Regarding the Inflation Reduction Act, the president said he wants to increase the number of drugs subject to Medicare price negotiations to 50 per year, up from 20 under current law. Biden also said he wants to expand the IRA’s $2,000 annual out-of-pocket cost cap for prescription drugs and $35 monthly copay cap for insulin to commercial plans, as they currently only apply to Medicare Part D. Additionally, the president vowed to defend the Affordable Care Act from repeal attempts and make the expanded subsidies that are set to expire after 2025 permanent. 

The White House on March 5 unveiled a “strike force” aimed at cracking down on unfair and illegal pricing, focusing on sectors including prescription drugs and health care, food and grocery, housing, and financial services. Set to be chaired by the Dept. of Justice and Federal Trade Commission, the strike force “will strengthen interagency efforts to root out and stop illegal corporate behavior that hikes prices on American families through anti-competitive, unfair, deceptive, or fraudulent business practices,” the Biden administration said. The White House simultaneously announced that its Competition Council will soon unveil new actions aimed at slashing credit card late fees, combating high internet costs and supporting small farmers; previously, the council helped drive HHS actions such as cracking down on problematic Medicare Advantage marketing practices. 

The U.S. Dept. of Justice (DOJ) has opened an antitrust investigation into UnitedHealth Group, according to an internal company document shared with AIS Health and a Wall Street Journal report citing unnamed people familiar with the matter.  

Federal regulators are reportedly seeking information about how the Minnesota-based company’s UnitedHealthcare insurance arm interacts with the many provider acquisitions that its Optum division has made in recent years — and how that relationship affects competition.  

One health care economist says that while many unanswered questions remain, the result of a different investigation into provider consolidation suggests that the DOJ’s probe of UnitedHealth could end in an antitrust lawsuit.  

Change Healthcare is the target of an ongoing cyberattack that is causing significant disruption for providers and pharmacists that rely on the UnitedHealth Group subsidiary to process claims, payments and authorizations.  

While two prominent credit-rating firms say the incident likely won’t affect the credit worthiness or earnings outlook of UnitedHealth’s overall enterprise, one industry expert says the Change cyberattack does still pose risks for the company — and puts similarly diversified health insurers on notice. 

“There’s just no guarantee that anybody’s going to be entirely safe from cyberattacks,” says Dean Ungar, a vice president and senior analyst at Moody’s Investors Service. “I think this does serve as a wake-up call or reminder to everyone in the industry…Even those [firms] that weren’t hit probably took this opportunity to take another look at what they’re doing and make sure that they’re protected — to the extent that you can be.” 

Part of a long-running lawsuit filed by Elevance Health, Inc. against The Cigna Group, over what Elevance considers inappropriate contract practices by Cigna's Express Scripts PBM, entered mediation mandated by the Second Circuit Court of Appeals, according to court documents and Elevance’s latest 10-K filing with the Securities and Exchange Commission (SEC). Elevance was seeking to recover $14.8 billion in damages and is now appealing a district court judge’s dismissal of its remaining claim. 

David Kaufman, an attorney at Laurus Law Group LLC, says that the mediation mandated by the Second Circuit is unlikely to do much to satisfy Elevance.  

“Perhaps the parties could reach an agreement through mediation that will be supervised by the court,” Kaufman says. “I don’t know how likely that is considering the magnitude of the money that they’re seeking.”