Medical Loss Ratio: Quarterly Trend
Quarterly medical loss ratio (share of each premium dollar spent on care) for the 6 largest US health insurers. The ACA requires 80-85%; higher means more on care, tighter margins.
Updated at 2026-05-10
The UnitedHealth Collapse
UnitedHealth (UNH) stock price and forward P/E (price over next-12-month consensus earnings), Jan 2024 to May 2026, through three shocks that erased ~$330B of market cap.
Dec 2024Brian Thompson killed (Dec 4)
Apr 2025Q1 earnings miss + guidance pull (Apr 17)
May 2025Optum DOJ probe disclosed (May 14)
May 2025Trough ~$280
Mar 2026Recovery to ~$340
Updated at 2026-05-10
Medicare Advantage Enrollment by Carrier
Annual Medicare Advantage enrollment by carrier (2020-2026). MA is the private-insurer version of Medicare, where CMS pays insurers a per-member subsidy.
Updated at 2026-05-10
STAR Ratings Distribution
CMS STAR ratings (1 to 5) by Medicare Advantage carrier for 2025; the 4-star-plus share drives bonus payments, and Humana's collapse from 94% to 25% cost about $3B.
| Carrier | MA Members | % in 4-star+ (2024) | % in 4-star+ (2025) | YoY | 5 | 4.5 | 4 | 3.5 | 3 | <3 |
|---|---|---|---|---|---|---|---|---|---|---|
UnitedHealthUNHDropped from 87% to 78%; modest revenue headwind | 10.1M | 87% | 78% | -9pp | 1 | 5 | 18 | 12 | 3 | - |
HumanaHUMLost ~$3B in QBP starting 2026; lawsuit filed against CMS; Mar 2025 ruling vacated cut-points but bonuses for 2026 already lost | 5.7M | 94% | 25% | -69pp | 1 | 3 | 6 | 11 | 4 | 1 |
CVS/AetnaCVSBest-performing large MA portfolio in 2025; minimal QBP impact | 4.3M | 87% | 81% | -6pp | 1 | 4 | 11 | 6 | 2 | - |
ElevanceELVFiled lawsuit; 23pp decline | 2.2M | 64% | 41% | -23pp | - | 1 | 5 | 9 | 4 | - |
CenteneCNCOnly major carrier to improve materially YoY; turnaround under new CEO | 1.3M | 22% | 55% | +33pp | - | 1 | 4 | 6 | 3 | 1 |
MolinaMOHSmall MA footprint; Medicaid-focused | 250K | 50% | 35% | -15pp | - | - | 3 | 7 | 2 | - |
Clover HealthCLOVSmall but high-quality MA portfolio; PPO plan rated 4-star | 80K | 80% | 90% | +10pp | - | 1 | 1 | 1 | - | - |
Oscar HealthOSCRACA-marketplace pure-play; exited MA after 2023 | - | - | - | - | - | - | - | - | - | - |
Updated at 2026-05-10
Days Claims Payable: Reserve Snapshot
Days Claims Payable, the days of medical claims an insurer could cover from reserves already set aside (healthy range 40-60 days), snapshot at Q1 2026.
DiversifiedACA-focusedMedicaid-focusedMA-focused
Updated at Q1 2026