Warren Buffett's firm buys $1.6B in UnitedHealth stock, boosting stock price

By Alan Goforth – Investors have sharply different responses to UnitedHealth Group’s ongoing legal, regulatory and financial turmoil. Although Warren Buffett’s Berkshire Hathaway has purchased a significant amount of stock, many members of Congress are selling theirs. The embattled insurance giant has weathered multiple challenges, from a massive cyberattack in early 2024 to the murder of former UnitedHealthcare CEO Brian Thompson in December. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Berkshire Hathaway's stake and market reaction: Berkshire Hathaway purchased more than five million shares worth $1.6 billion, and that regulatory filing prompted about a 13% jump in UnitedHealth's share price. At the same time, some members of Congress have sold as much as $1.2 million of company stock while buying stock valued at $950,000, showing divergent investor responses. Those opposing moves illustrate differing assessments of UnitedHealth's near-term outlook.

2. Multiple legal and reputational challenges have weighed on UnitedHealth: The company has faced a massive 2024 cyberattack, reporting by The Guardian alleging payments to nursing homes that may have harmed patient care, the murder of former CEO Brian Thompson, and a Department of Justice investigation into allegations of inflated diagnoses for Medicare Advantage payments. These developments coincided with the company's stock declining nearly half in 2025, making it the worst performer in the Dow Jones Industrial Average. The accumulation of scandals and probes has increased uncertainty for investors and regulators.

3. Company actions and financial outlook show efforts to stabilize but uncertainty remains: UnitedHealth's leadership acknowledged “pricing and operational mistakes,” completed a $3.3 billion acquisition of Amedisys, and added governance measures including a new lead independent director and a public responsibility committee. The company revised and then suspended its 2025 forecast before projecting at least $14.65 in net earnings per share and total annual revenue between $444.5 billion and $448 billion. Observers note Berkshire's investment may have improved sentiment for now, but whether a sustained turnaround follows remains uncertain.

Judge halts implementation of some Trump administration changes that would chip away at Obamacare

By Devan Cole and Tami Luhby – A federal judge in Baltimore has halted certain provisions of an Affordable Care Act regulation that the Trump administration is set to implement on Monday and could lead to as many as 1.8 million Americans losing their health insurance. The decision issued Friday by US District Judge Brendan Hurson puts on hold a half a dozen changes in the rule, which critics say will make it harder to enroll in and maintain Obamacare coverage, as well as make it more expensive. Read Full Article...

HVBA Article Summary

1. Partial Block on Health Insurance Rule Changes: Judge Hurson issued a partial injunction against specific provisions of a new federal rule that would have tightened enrollment criteria in the Affordable Care Act exchanges. These blocked measures include enhanced income verification requirements, allowing insurers to deny coverage to individuals with outstanding premium payments, and imposing a temporary $5 monthly charge on certain consumers until their eligibility for subsidies is confirmed. While these parts were halted, other portions of the rule were allowed to move forward.

2. Legal Reasoning and Public Interest Concerns: The judge agreed with arguments made by a coalition of Democratic-led cities that the Centers for Medicare and Medicaid Services (CMS) may have acted beyond its legal authority and in contradiction to existing federal law. He found that allowing the blocked provisions to proceed could cause significant and irreversible harm to city healthcare systems by increasing the number of uninsured residents. This would lead to financial strain on emergency and public health services, potentially undermining the quality and affordability of care.

3. Lawsuit Status and Broader Legal Challenge: The ruling is a temporary measure, meaning the blocked provisions will remain on hold while the legal case continues. The lawsuit, led by cities represented by Democracy Forward, argues the CMS rule undermines the goals of the Affordable Care Act. Separately, a similar case filed by Democratic state attorneys general is still pending in Massachusetts. CMS has not issued a comment on the ongoing litigation, and the broader legal challenges could influence future implementation of the contested policies.

BCBS $2.8B antitrust settlement approved by federal judge

By Allison Bell – A federal judge has given final approval to a $2.8 billion settlement between health care providers and Blue Cross and Blue Shield carriers over allegations that the Blues worked together to hold down payments to the providers. U.S. District Judge R. David Proctor also called for the Blues to make efforts to increase market competition, and he allowed for about $657 million in attorneys' fees and $102 million in attorneys' costs and according to an order posted earlier this week. The Blues agreed on the $2.8 billion payment figure in October 2024 and have denied any wrongdoing. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Final approval, fees and judge's directives: A federal judge gave final approval to a $2.8 billion settlement between health care providers and Blue Cross and Blue Shield carriers and the order allowed roughly $657 million in attorneys' fees and $102 million in attorneys' costs. Judge R. David Proctor also called for the Blues to take steps to increase market competition as part of the resolution. The settlement resolves long-running antitrust claims alleging the Blues coordinated to hold down payments to providers.

2. Potential impact on employers and the BlueCard program: The agreement requires changes to the BlueCard program, which employers use to provide access to a national network of providers for fully insured group coverage or administration of self-insured plans. Those changes could make BlueCard provider access and pricing more complicated for employers and plan participants. The article highlights uncertainty about how the new provider agreement will affect employers who currently rely on BlueCard networks and negotiated contract terms.

3. Litigation history, class scope and opt-outs: The antitrust litigation began in 2012 and was centralized in a multidistrict litigation in the Northern District of Alabama in 2013 with separate tracks for subscribers and providers. The provider class contains about 3.3 million members, and about 6,400 providers opted out of the settlement, including large systems such as the Mayo Clinic and AdventHealth. Supporters note the number of opt-outs is small relative to the class size, and the Blues had agreed to the settlement amount while denying wrongdoing.

Same Surgery, $220K Apart: Why Providers & Employers Need to Rethink Value Amid Price Disparities

By Katie Adams – Market research firm Trilliant Health released research Monday revealing striking differences in the prices providers charge for identical services. The report, which examined data from 2,659 hospitals and 3,491 ambulatory surgery centers, found that commercially insured patients pay widely varying amounts for the same services — and these costs are primarily absorbed by employers. Read Full Article...

HVBA Article Summary

1. Massive Price Variation in Healthcare Costs Revealed: A recent analysis found that negotiated rates for common medical procedures, such as coronary bypass surgery, vary by more than $200,000 depending on the insurer and hospital, even for the same treatment at the same facility. Experts argue that this lack of consistency is both surprising and problematic, as patients’ costs are determined primarily by their insurance provider rather than the care itself.

2. Price and Quality Show No Clear Connection: Researchers also observed that higher healthcare prices do not necessarily translate into better care, including among top-ranked hospitals. Unlike in other industries, where consumers expect higher costs to signal higher quality, healthcare prices remain unreliable indicators, challenging the assumption that “you get what you pay for.

3. Systemic Reform and Employer Responsibility Urged: While price transparency efforts have increased, experts stress that patients alone cannot resolve these issues by shopping for care. Instead, large-scale reforms are needed, and employers — who finance nearly a third of U.S. health spending — are being urged to demand more value-driven plans. Employers are positioned to use their influence to hold insurers and providers accountable for delivering high-quality care at sustainable prices.

The 340B program, explained

By Alexandra Murphy - More than three decades ago, Congress created the 340B program to help safety-net hospitals and clinics​​ expand resources and care for underserved communities. By requiring pharmaceutical companies to offer deep discounts on outpatient drugs, the program has become a hallmark resource to help health systems support vulnerable patients. In recent years, however, the program has drawn scrutiny from federal lawmakers as several drugmakers have introduced alternative rebate and drug pricing models, raising questions about the direction of the program. Read Full Article…

HVBA Article Summary

1. Increased Scrutiny and Legal Disputes Over 340B Usage: Hospitals’ use of 340B program savings has come under intensified scrutiny, particularly following a Senate report alleging large health systems were profiting by charging patients high prices for discounted drugs. While hospitals like Cleveland Clinic and Bon Secours Mercy Health defend their compliance with federal rules, drug manufacturers and federal courts have challenged hospital practices and contract pharmacy arrangements, leading to lawsuits and new state-level legislative efforts.

2. Pushback Against Rebate-Based Discount Models: Drugmakers, including Johnson & Johnson, Eli Lilly, and Sanofi, have introduced rebate-based alternatives to traditional 340B discounts, arguing these models increase transparency and reduce abuse. However, hospitals and the Health Resources and Services Administration (HRSA) argue such models violate the 340B statute by shifting upfront costs to hospitals. Legal battles have ensued, with a federal judge recently rejecting Johnson & Johnson’s challenge, while HRSA launched its own pilot rebate program set to begin in 2026.

3. Ongoing Debate Over Program Integrity and Purpose: As legal and regulatory shifts unfold, hospitals continue to advocate for the original mission of the 340B program—supporting care for underserved populations. Health systems like Ascension and Prisma Health emphasize that savings fund critical services such as rural pharmacy access and patient assistance programs. However, concerns persist over potential financial burdens from rebate models and changing Medicaid eligibility, which could undermine the program’s ability to sustain care for vulnerable communities.

Healthcare costs projected to rise 9% in 2026

By Alyssa Place – Employers are bracing for another year of significant healthcare cost increases in 2026, as cost management and affordability become top priorities for benefit leaders. Business Group on Health's 2026 Employer Health Care Strategy Survey projects a median 9% rise in medical cost trends — or 7.6% after plan design changes. This comes on the heels of the highest back-to-back jumps in a decade. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Projected Overall Increase and Context: Business Group on Health's 2026 Employer Health Care Strategy Survey projects a median 9% rise in medical cost trends for 2026, or 7.6% after employers implement plan design changes. These projected increases follow the highest back-to-back jumps in a decade, signaling continued pressure on employer-sponsored benefits. Employers are positioning cost management and affordability as top priorities going into the year.

2. Major clinical cost drivers and employer responses: Employers identify cancer as the single largest driver of healthcare costs and report rising utilization across chronic conditions and mental health services. Use of obesity medications, including GLP-1s, has surged and many employers are imposing prior authorization and mandatory weight-management program requirements to manage those costs. Mental health, musculoskeletal, cardiovascular, diabetes, and autoimmune conditions are also contributing to growing utilization and spending.

3. Pharmacy spending and calls for systemic change: Employers expect pharmacy costs to rise about 11–12% into 2026, a trajectory described as unsustainable without broader reforms. The report has prompted calls for systemwide changes and alternative pharmacy benefit management models that increase transparency and reduce reliance on rebates. Concurrently, employers are asking vendors for greater accountability, prioritizing quality and value, better navigation to high-value providers, integrated care coordination, and expanded prevention efforts such as more comprehensive cancer screening coverage.

Oral Wegovy’s Pending Approval Puts Spotlight on Viability of High-Dose Peptides

By Nick Paul Taylor – While the 10-fold increase in dose over injectable Wegovy has raised questions about the launch, Novo Nordisk has assured investors it has the manufacturing capacity to roll out oral semaglutide without restrictions on supply. In the fourth quarter, the FDA is set to decide whether to approve an oral 25 mg dose of semaglutide, the active ingredient in Wegovy. Novo Nordisk’s progression of oral Wegovy to the cusp of approval has raised new questions about the company’s peptide supply chain. Read Full Article...

HVBA Article Summary

1. Novo Nordisk Asserts Manufacturing Readiness for Oral Semaglutide Launch: Novo Nordisk claims it is fully prepared to support the U.S. launch of its 25 mg oral semaglutide for obesity without supply restrictions, despite the manufacturing challenges associated with a tenfold dose increase compared to injectable Wegovy. The company has invested $6.5 billion in U.S. manufacturing capacity and emphasized that production will take place domestically. Both company executives and outside analysts have reinforced confidence in Novo’s ability to meet demand, pointing to improvements in production processes and flexibility in using the active pharmaceutical ingredient (API) across multiple products.

2. Manufacturing and Scalability Challenges Loom for High-Dose Oral GLP-1s: The commercial viability of high-dose oral GLP-1 peptide drugs remains uncertain, with experts suggesting that doses above 25 mg may be difficult to scale effectively. While Novo selected a 25 mg dose after testing a 50 mg version, other companies like Viking Therapeutics are pursuing even higher doses (up to 120 mg), raising concerns about manufacturing costs and profit margins. Although some manufacturers argue that peptide production prices have dropped, enabling broader scalability, the debate over what dose levels are commercially feasible continues across the industry.

3. Clinical Efficacy Likely to Determine Market Success Over Manufacturing Edge: While small molecule drugs like Eli Lilly’s orforglipron offer manufacturing advantages due to their simpler production processes, analysts believe that clinical efficacy will be the key factor in determining market share for oral obesity treatments. Novo’s semaglutide has emerged as the leading candidate in the oral segment, especially after Lilly’s drug showed lower-than-expected weight loss in a recent trial. Experts suggest that regardless of cost advantages, the drug delivering the most compelling clinical results will shape the competitive landscape.