From Our Desk Original analysis · Health
All Health insights →UnitedHealth, Presbyterian and Humana's 2027 Medicare Advantage Exits Trace to County Benchmark Math
UnitedHealth's 2027 Medicare Advantage list covers 34 counties; Presbyterian exits 30,000 members and Humana 600,000. The benchmark quartile, star rebate, and risk-score math decide which counties still clear a bid.
By Beth · 12 min read · Aug 13
Oscar Health's Loss Ratio Fell to 79.2 Percent. It Booked Only a Sliver of the Risk-Adjustment Upside Behind It
Oscar Health's medical loss ratio fell to 79.2% in Q2 2026 as membership grew 46% to 2.96 million, yet executives booked only a sliver of favorable risk adjustment on just four months of 2026 claims data.
By Beth · 12 min · Aug 12
Humana Sheds 600,000 Medicare Advantage Members for 2027, Recaptures Fewer Than Half
Humana will exit Medicare Advantage plans covering 600,000 members for 2027, about 8% of its base, and expects to recapture only 240,000, a retention math that resets morbidity in its surviving risk pool.
By Beth · 12 min · Aug 10
Cigna's 84.5% Medical Ratio Splits From the Medicare Advantage Trend Story
Cigna's Q2 2026 medical care ratio came in at 84.5%, versus Humana's 91.2% and Elevance's 89.7%, as softer surgical and outpatient spending split its commercial book from Medicare Advantage cost trend.
By Beth · 13 min · Aug 7
Aetna's 250bp MBR Drop Rode a $471M Reserve Reversal
Aetna's Q2 2026 medical benefit ratio fell 250 bps to 87.4%, but $1.2B of six-month favorable prior-year development and a lapped $471M premium deficiency reserve did much of the work (CVS Health, August 2026).
By Beth · 11 min · Aug 6
Centene's Marketplace Book Shrank 41%. Its Risk-Adjustment Position Swung Favorable With It
Centene's health benefits ratio fell to 89.6% and net income swung to $1.1 billion in Q2 2026, as its Marketplace book fell to 3.5 million from 5.9 million and risk adjustment turned favorable.
By Beth · 11 min · Aug 5
UnitedHealthcare's June Plan F Reprice Lands Alongside 35%-Plus Closed-Block Filings
UnitedHealthcare repriced its AARP Plan F block up to $47.02 a month on June 1, 2026, while Humana, LifeShield National, and others filed 34% to 39% closed-block increases feeding Medigap's anti-selection spiral.
By Beth · 10 min · Aug 5
Medicare Advantage's Quality Bonus Hits $13.4 Billion While the Qualified Base Shrinks to 68%
Medicare Advantage's quality bonus program will pay $13.4 billion in 2026, up from $12.7 billion, but the share of enrollees in bonus-qualified plans fell to 68% from 75%, reshaping rebate dollars for 2027 plan bids.
By Beth · 10 min · Aug 3
Medicaid Work Rule's 2.3M Exits Hit Self-Insured 2027 Assumptions
The Medicaid work rule took effect July 31; CMS projects 2.3 million exits in FY2027. Self-insured plans absorb the shift twice: sicker migrating enrollees, and uncompensated care repriced into commercial rates.
By Beth · 10 min · Aug 3
- UnitedHealth Investor Suit Alleges Security, Governance LapsesClaims Journal · 10h ago
- People With Disabilities Say Medicaid’s Limits on Income Stifle Career AdvancementKFF Health News · 14h ago
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- The biggest payer and provider trends from Q2Fierce Healthcare · Yesterday
- ‘Way off the reservation’: Brookings researchers slam assumptions in CMS work requirements ruleHealthcare Dive · Yesterday
ACA Tracker 2027 individual-market rate filings to date
Rate Review →Sourced from federal Rate Review and state DOI filings. Green indicates improvement vs. prior-year period.