UnitedHealth will no longer offer Medicare Advantage plans in 16 U.S. counties in 2026, affecting 180,000 members due to higher costs and reimbursement pressure. The company’s government programs head, Bobby Hunter, cited CMS funding cuts, rising healthcare costs, and increased utilization as challenges. UnitedHealth will continue to operate in most states.

The government pays private insurers to run Medicare Advantage plans for those 65 and older or with disabilities. UnitedHealthcare has the most enrolled members among competitors like CVS Health and Humana. The company suspended its full-year guidance after missing earnings for the first time since 2008, attributing the first-quarter earnings miss to unexpected costs in its Medicare Advantage business.

UnitedHealth faces a $4 billion risk to insurance profits in 2026 due to regulatory changes lowering payments for certain conditions. The company plans to close certain plans with about 200,000 members to mitigate the impact. Government funding is expected to drop by 20% in 2026 compared to 2023.

Over 100 plans with around 600,000 members will cease operations, mainly comprised of preferred provider organizations. Patients may be directed towards health maintenance organizations, limiting provider options. Plan closures will focus on rural areas to streamline operations and bring cost-effective care. UnitedHealth seeks a sustainable model to serve these communities effectively.

Read more at Yahoo Finance: UnitedHealth to exit Medicare Advantage plans in 16 US counties