UnitedHealth Is Cashing In On The Open Enrollment Crisis
By Neal K. Shah
November 7, 2025
As 24 million Americans begin shopping for health insurance during the Affordable Care Act marketplace’s open enrollment period, Congress is deadlocked over whether or not to extend premium tax credits that help the vast majority of these people afford coverage. At the same time, UnitedHealth Group, the country’s largest insurer, just beat Wall Street’s profit expectations.
The timing isn’t coincidental. It’s the business model — since no matter what happens to the country’s health care safety net, insurers like UnitedHealth are poised to win.
Insurance companies have filed rate assumptions for both the extension and expiration scenarios, and under both options, they profit. Meanwhile, consumers face spiking premiums, soaring out-of-pocket costs, and debilitating uncertainty. What looks like political gridlock is, in fact, a strategic opportunity for the insurance industry.
Shutdown = Profit
As the shutdown enters its fifth week, becoming the longest shutdown in history, the standoff centers on a technical-sounding issue: whether to extend enhanced premium tax credits for Affordable Care Act plans.
The 2010 Affordable Care Act’s enhanced premium tax credits were first expanded under the 2021 American Rescue Plan to make marketplace coverage more affordable during the pandemic, and they were later extended by the 2022 Inflation Reduction Act. Their pending expiration at the end of 2025 triggered the current standoff and government shutdown, as Democrats demand their renewal to prevent millions from losing coverage while Republicans insist on separate negotiations before reopening the government.
Meanwhile, insurers have filed two sets of premium rates — one assuming subsidies continue, one assuming they expire — and they’re profiting either way.
For example, according to the Kaiser Family Foundation, one insurer in Rhode Island proposed a 21 percent increase if premium subsidies expire — but also planned to increase rates by 16 percent if the subsidies continue. In Vermont, MVP Health Plan filed two sets of rate increases, assuming that healthy individuals will drop at twice the rate of other individuals if subsidies are not extended, leading to a sicker risk pool.
When families logged into healthcare.gov on Nov. 1, they saw the damage. Even without factoring in the expiration of the enhanced tax credits, average premiums are jumping 26 percent, the largest increase since 2018. And if Congress fails to extend the tax credits by year’s end, out-of-pocket costs will more than double for the average enrollee — rising from $888 in 2025 to $1,904 in 2026.
The political calculation is transparent. Republicans argue there’s “plenty of time” to address subsidies, since they don’t expire until the end of the year. But open enrollment has already started. Families making coverage decisions today have no idea what they’ll actually pay. Even if Congress acts later, insurance commissioners warn that consumers who see inflated premiums now won’t come back.
That uncertainty is profitable. While politicians posture, insurers have positioned themselves to win regardless of the outcome. UnitedHealth just raised its 2025 profit forecast to at least $16.25 per share, beating expectations despite — or perhaps because of — the chaos.
Other major insurers have also beaten recent Wall Street predictions, Cigna Group reported an adjusted third-quarter profit of $7.83 per share, above estimates.
When analyzing their 2026 rate filings, researchers found that insurers factored potential subsidy expirations into their premium increases, anticipating that healthier enrollees would drop coverage, leaving behind a sicker, more expensive pool to justify future rate hikes.
This dynamic underscores the central critique of the Affordable Care Act since its inception: It props up a bloated private insurance system rather than truly addressing the underlying cost of care. By subsidizing premiums instead of reducing hospital, drug, and administrative expenses, the health care reform law effectively channels billions of taxpayer dollars into sustaining inflated health care prices rather than reforming them.
Employer-sponsored plans are not immune either, with plans becoming ever more expensive for both…
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