Is This The Beginning of The End for Big Insurance?
By Wendell Potter
Jan 28, 2026
This week we are seeing what a tragic mistake we as a country made in turning our health care system over to corporations like UnitedHealth Group that live and die on Wall Street. And it’s only Wednesday.
I hope lawmakers are paying attention because we very well could be heading into an ongoing collapse of the health insurance industry’s market capitalization and the ability of insurance giants to keep the lights on without a taxpayer bailout. I am not crying wolf. Access to care for hundreds of millions of Americans is at stake.
Yesterday, UnitedHealth reported fourth quarter 2025 earnings and alarmed investors, not just about past performance but about the company’s 2026 revenue outlook. By the end of trading on the New York Stock Exchange, UnitedHealth’s share price had fallen an astonishing 20% to $282.70. The company’s news was so dismal, at least to investors, that it dragged the stock price of all six of its for-profit competitors down with it. It even pushed the Dow into negative territory on a day when both the S&P and Nasdaq were up.
In a single day, those seven giants lost as much as $100 billion in market capitalization. The trading volume was off the charts. Collectively, those companies saw more than 145 million of their shares traded, at least 10 times more as usual.
Today could be another very bad day for health insurers. Elevance, the conglomerate that owns Anthem Blue Cross plans in 14 states, became the second of those seven to announce 2025 earnings and outlook for this year. Like UnitedHealth, the company’s “guidance” – the revenue and profit expectations of the company’s leadership – for 2026 initially disappointed investors (Elevance also expects a decrease in both revenues and profits this year). Shares of Elevance and most of the other companies in the sector fell in pre-market trading, although Elevance and some of the others began to recover a bit after the market opened at 9:30.
It wasn’t just what UnitedHealth and Elevance reported that spooked investors this week. They were equally disappointed in a highly anticipated announcement by the Trump administration’s Center for Medicare & Medicaid Services. Around this time every January, CMS discloses how much it intends to increase payments to private insurers that sell Medicare Advantage plans. On Monday, minutes after the NYSE closed for the day, CMS sent shockwaves through the industry and investment community when it announced a proposed increase of just 0.09% for 2027, far below what industry executives and shareholders had expected. CMS also stunned industry executives – and even reform advocates like me – when it pledged to significantly increase efforts to prevent insurers from overbilling the government.
Why you should care
What we are seeing play out on Wall Street is a not-so-slow-motion train wreck that will make it even harder for Americans to get the care they need as these companies take actions to try to get back into investors’ good graces. And we can all expect to see these companies jack up premiums even more, putting coverage out of reach for more and more of us.
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It wasn’t so long ago that these companies were Wall Street darlings. That began to change in late 2024 when insurers’ executives had to tell their shareholders that they were struggling to control health care costs. As they explained it, despite their best efforts to avoid paying claims, people enrolled in their health plans – especially in their Medicare Advantage plans – were nevertheless somehow getting more care than the corporate executives had expected. That and the fact that CMS actions initiated during the Biden administration to reduce overpayments to Medicare Advantage plans were going into effect.
The insurers’ executives had hoped the Trump administration would be more generous and less attentive to the rampant waste, fraud and abuse in the Medicare Advantage program. You can imagine how shocked those executives – and shareholders – were on Monday to learn that Trump’s CMS said it was going to be tougher and more tight-fisted than anyone expected. (You can be certain industry lobbyists will pull out all the stops to get Trump to backpeddle on the planned MA crackdown.)
The carnage on Wall Street started even before trading opened at the New York Stock Exchange yesterday morning. UnitedHealth posted its fourth quarter/full year 2025 earnings report around 6 a.m., a couple of hours before its executives held their quarterly investor call with Wall Street financial analysts. Investors, to put it mildly, were startled by the company’s lackluster fourth quarter performance and what CEO Stephen Hemsley and other executives had to say about the future. Total revenues, they predicted, likely would be lower in 2026 than in 2025, a first for this company.
Worst thing ever: Shrinkage
I can just imagine how stunned the company’s shareholders were to hear that. UnitedHealth became the world’s largest health care company by revenue after more than two decades of acquisitions and constant price increases. It seemed to be an unstoppable growth machine with a vertical integration strategy that would ensure constant revenue expansion. Revenue had increased so fast in recent years, in fact, that UnitedHealth leapfrogged up the Fortune 500 of American companies to the #3 spot. Only Walmart and Amazon took in more annual revenues than UnitedHealth. To hear that that growth not only was slowing but that the company was shrinking – yes, shrinking – sent shock waves across Wall Street and throughout the industry.
In Washington, meanwhile, Industry lobbyists had…
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