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A Simply Wall St screen flags three large US health insurers as well placed if interest rates stay higher for longer: Elevance Health, CVS Health, and Humana. The screen favours quality value companies with solid balance sheets and dependable cash flow. Elevance Health has a market value of about $95.1 billion. Its Health Benefits unit brings in about $170.4 billion of revenue, and Carelon's CarelonRx and Carelon Services add about $45.1 billion and $30.1 billion. CVS Health is valued at about $119.5 billion, with Health Services revenue of about $200.5 billion. It took a $1.1 billion charge tied to Medicare and Individual Exchange businesses and a $1.2 billion restructuring charge for store closures. Humana, valued at about $50.7 billion, draws about $139.7 billion from insurance and $24.7 billion from CenterWell. Regulators are sharpening their focus on its risk adjustment data and prior authorization standards.

Elevance earns $1.4 billion quarterly profit as membership falls by 487,000 and insurer calls 2026 the Medicaid trough. Published Oct 23, 2026 9:45 AM EDT By Cole Mercer Elevance Health, the parent of Anthem and Wellpoint plans, reported a $1.4 billion third-quarter profit on October 21 while covering 487,000 fewer people than a year earlier. Executives told investors that 2026 marks the low point for the company's Medicaid profit margins and that they expect improvement next year. Elevance's medical membership stood at about 44.9 million on September 30, according to Fierce Healthcare. Quarterly profit rose from $1.2 billion a year earlier, though profit for the first nine months of the year fell to $4.6 billion from $5.1 billion. Elevance raised its full-year outlook to adjusted earnings of at least $29 per share. For the roughly 8.2 million people Elevance covers through Medicaid in more than a dozen states, the outlook is more than investor language. The company is leaving some Medicaid markets, tightening spending on certain services and preparing for federal work requirements that begin in January. Each of these can affect whether families keep their plan, their doctors and their therapies. Profits rise while enrollment shrinks. The "trough" description comes from Elevance itself. Chief Financial Officer Mark Kaye said the company's progress reinforces its view that "2026 is the trough for Medicaid margins," with improvement expected in 2027. Elevance had projected its Medicaid business would run at an operating margin of about negative 1.75% this year. It now expects slightly better results after several states raised their payment rates in July, according to Healthcare Dive's earnings coverage. CEO Gail Boudreaux told investors that "Medicaid is moving from stabilization to improvement." Insurers say their Medicaid troubles began after pandemic-era coverage protections ended and states rechecked eligibility. Healthier members tended to leave the program, while those who stayed needed more care, and state payment rates lagged behind those higher costs. Elevance's third-quarter earnings release reported a benefit expense ratio, the share of premium revenue spent on medical care, of 90.6%, an improvement from a year earlier. Other lines of business helped. Elevance now expects to end 2026 with at least 1.2 million individual ACA marketplace members, up from a prior forecast of 1 million. Its Medicare Advantage plans also became more profitable after the insurer trimmed underperforming plans and shifted toward HMOs with narrower networks, Healthcare Dive reported. The other side of that ledger is coverage. Each member an insurer drops or loses must find another plan, reapply for Medicaid, or go uninsured. For a family, that can mean new doctors, new approval requirements and paperwork deadlines. Families in Medicaid face a shifting map. Elevance exited the Washington, D.C., Medicaid market this summer and has signaled more exits through the end of 2027 in states where it does not see a path to sustainable results. In Louisiana, the Healthy Blue Medicaid contract, a joint venture with Blue Cross and Blue Shield of Louisiana, ends December 31, and Elevance is cutting 216 jobs tied to the wind-down, Becker's Payer Issues reported. More than 290,000 Healthy Blue members must choose another plan during a special enrollment period that runs from October 15 through November 16, according to Becker's. Elevance has also moved to control spending on behavioral health care, including applied behavior analysis therapy for children with autism, which Healthcare Dive described as a major driver of spending. Parents whose children rely on that therapy may face added reviews or authorization steps and should keep treatment records and provider letters on hand. A larger change arrives in January. Federal law now requires many adults in the Medicaid expansion group to show work, school, or community service hours to keep coverage. In an interim final rule issued in June, federal regulators projected about 2.3 million people would be disenrolled in fiscal year 2027 because of the requirement, according to a HealthInsurance.org summary of the federal interim final rule. Iowa begins enforcing it December 1, ahead of the national start. Felicia Norwood, Elevance's chief health benefits officer, said the company is "encouraged by what we're seeing in our 2027 rates." She also said the effect of work requirements will vary state by state and that Elevance will wait to see how states carry them out. Pressure spreads to hospital bills. The company's cost-control push also reaches hospitals. Elevance announced on September 29 that it will require hospitals to report the physical location where care was delivered on claims and will adjust payment for some off-campus services across its commercial, Medicare Advantage and Medicaid plans, with changes phased in through the end of 2027. Felix Segre, director of revenue integrity at Houston-based Memorial Hermann Health System, told Becker's Hospital Review that the policy "could mean added billing checks, more rework and payment delays when location details do not match payer records." Patients are not the target of the rule, but billing disputes between insurers and hospitals can surface as delayed claims or confusing statements. Several questions remain open. Elevance has not named which additional Medicaid states it may exit, and states are still finalizing how they will carry out work requirements. Federal enrollment data showing the real-world effect will lag by months. Medicaid members can take practical steps now. Update your address and phone number with your state Medicaid office so renewal and work-requirement notices reach you. Read any letter about plan changes promptly, ask whether your doctors are in the new network, and request continuity-of-care protections if you are in the middle of treatment. Marketplace open enrollment begins November 1, but adults who lose Medicaid because they did not meet work requirements are generally barred from marketplace premium tax credits under the 2025 law, so those families should check their options carefully. Key questions answered. What did Elevance report? A third-quarter profit of $1.4 billion, up from $1.2 billion a year earlier, and about 44.9 million medical members, 487,000 fewer than a year ago. What does "trough year" mean? It is the company's own description. Elevance executives say 2026 is the low point for Medicaid profit margins and expect improvement in 2027. Which Medicaid members could be affected? Members in markets Elevance exits, including Washington, D.C., and Louisiana's Healthy Blue plan, plus expansion adults subject to new work requirements. When do Medicaid work requirements begin? Most states must begin enforcing them in January 2027. Iowa starts December 1, 2026. What should Medicaid members do now? Update contact details with the state Medicaid office, read all notices quickly, confirm doctors are in network, and ask about continuity of care if in treatment. Will this change hospital bills? Elevance's new billing rules for off-campus care target hospitals, not patients, but disputes can delay claims. Patients who receive confusing bills should call their insurer and the hospital billing office. Published by Medicaldaily.com