Health Insurers Report Lower Medical Loss Ratios in First Quarter

Health insurance companies including UnitedHealthcare, CVS Health’s Aetna, Centene and Blue Cross and Blue Shield plans owned by Elevance Health reported lower costs from patients submitting claims in the first quarter of 2026. UnitedHealth Group, the nation’s largest health insurer, said its medical loss ratio fell to 83.9 percent in the first quarter of 2026 from 84.8 percent in the first quarter of 2025.

The medical loss ratio measures the percentage of premium revenue spent on medical costs. The company’s full-year adjusted medical care ratio was 88.9 percent in 2025 compared with 85.5 percent in 2024. Most health insurers had faced medical loss ratios around 90 percent or higher for much of the prior two years amid rising medical expenses.

UnitedHealthcare’s adjusted medical care ratio exceeded 91 percent in the fourth quarter of 2025. The first-quarter improvement prompted a positive reaction in financial markets.

Centene said its enrollment fell by 2 million to 3.58 million at the end of the first quarter from 5.54 million at the end of the prior year and 5.62 million in the year-ago quarter. Elevance Health’s individual plan enrollment remained flat at 1.4 million.

The decline follows the expiration of enhanced premium tax credits that had been in place under prior legislation. Companies and industry observers stated that some customers could no longer afford coverage or shifted to lower-premium bronze plans with higher deductibles.

Elevance Health operates Blue Cross and Blue Shield plans in 14 states. The rating agency cited ongoing elevated healthcare utilization trends, potentially higher acuity in the Medicaid risk pool driven by program changes in the 2025 tax and spending bill, and the expiration of enhanced subsidies on Dec.

31. A KFF analysis conducted last fall projected that middle-income Americans as well as those with low incomes would face major increases in out-of-pocket premiums after the enhanced tax credits ended. Customers have reported premium increases of two to three times this year.

Across the industry, the changes contributed to reduced enrollment and decisions by some insurers to exit the market, including steps taken by Cigna and CVS Health. The enhanced subsidies, originally introduced in 2022, had expanded enrollment in marketplace plans to more than 24 million.

A smaller insured population may lead to further shifts in risk pools and cost structures for remaining plans.