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The “Big Five” have reported their financial and enrollment results for the first calendar quarter of 2026. The “Big Five” are the five largest publicly-traded insurers, measured by enrollment, in the Medicaid managed care market. Four of them—United Health Group, Elevance, CVSHealth/Aetna, and Centene, in that order—were also the four largest commercial health insurers by…

The Q4 2025 results for the “Big Five” Medicaid managed care companies are now available.  These publicly-held companies—Centene, CVSHealth/Aetna, Elevance, Molina, and UnitedHealth Group—together control about half of the Medicaid managed care market, so their performance matters to tens of millions of Medicaid beneficiaries. (The results for prior quarters in 2025 are here, here, and…

The lead story of 2025 is the enactment of H.R. 1, which will dramatically alter the Medicaid coverage and financing landscape over at least the next three years.  The primary target of the law’s Medicaid cuts were the 41 states (including DC) that have elected to cover the expansion adults; of these, 34 contract with…

Q3 2025 is the first quarter of a new chapter in the Medicaid managed care narrative.  At the beginning of the quarter, H.R. 1 was enacted.  As explained by our colleagues Edwin Park and Sabrina Corlette, the new law will upend Medicaid enrollment and financing for years to come, cutting federal payments to states by…

2024 was a year of transition for Medicaid managed care.  At the federal level, there were significant revisions in regulatory requirements relating to access to care and increases in transparency about MCO performance.  At the state level, the end of the unwinding of the public health emergency continuous eligibility requirement meant the end of the…

On November 1, CMS posted on its website Medical Loss Ratios (MLRs) for individual Medicaid managed care organizations (MCOs) in 2018, 2019, and 2020.  These data come from the MLR Summary Reports that states are required to submit to CMS.  This CMS action follows the posting on July 15 of the first tranche of Managed…

The Q2 2024 earnings reports for the “Big Five” Medicaid managed care companies are in.  They tell us that the PHE unwinding is winding down, but it’s still driving declines in Medicaid enrollment for the companies as a group. Here are the numbers. For the fifth consecutive quarter, beginning with Q2 2023, Medicaid enrollment for…