Medicare Scramble: Wall Street Wants Insurers to Dump Costly Seniors

By Wendell Potter - Wall Street is speaking loudly to Medicare Advantage insurers: If you want us to stick with you, keep dumping seniors who are pinching your profit margins. Investors continue to punish UnitedHealth Group since the company downgraded its 2025 profit expectations on April 17. On Friday, UnitedHealth’s stock price hit not only a 52-week low—$393.11—but its lowest point in years. The last time UnitedHealth’s stock price went below $400 a share was on October 14, 2021. Read Full Article…

HVBA Article Summary

1. UnitedHealth punished for absorbing costly enrollees: UnitedHealth’s shares have dropped over 33% since last November, including a 23% plunge in a single day after revealing it will earn less than expected from 400,000 new Medicare Advantage members—many of whom were dropped by rivals Humana and CVS to improve their own profitability.

2. Rivals rewarded for strategic member cuts: Humana, CVS, Cigna, and others dropped a combined 1.3 million high-cost Medicare Advantage enrollees at the end of 2024, boosting their stock performance and investor confidence. CVS shares have surged over 50% this year, and Humana’s stock has also rebounded, signaling Wall Street approval of aggressive cost-cutting tactics.

3. Massive profits and mounting political resistance: Despite stock volatility, UnitedHealth still posted $9.1 billion in Q1 profits and led the for-profit insurers that earned $70 billion collectively last year. As scrutiny of Medicare Advantage grows, these companies are expected to increase lobbying to protect the program’s lucrative revenues, which topped $1.5 trillion in 2024.

IRS unveils new HSA limits for 2026. Here’s what investors need to know

By Kate Dore - The IRS on Thursday unveiled 2026 contribution limits for health savings accounts, or HSAs, which offer triple-tax benefits for medical expenses. Starting in 2026, the new HSA contribution limit will be $4,400 for self-only health coverage, the IRS announced Thursday. That’s up from $4,300 in 2025, based on inflation adjustments. Read Full Article…

HVBA Article Summary

1. HSA contribution limits and eligibility are increasing for 2026: The maximum contribution for savers with family coverage will rise to $8,750 in 2026, up from $8,550 in 2025, according to the IRS. To contribute, individuals must be enrolled in a high-deductible health plan, defined for 2026 as having at least a $1,700 deductible for self-only coverage or $3,400 for family coverage. Additionally, the out-of-pocket maximum can’t exceed $8,500 for individuals or $17,000 for families.

2. HSAs offer triple-tax benefits and powerful long-term savings potential: Health savings accounts provide three key tax advantages: contributions are tax-deductible, earnings grow tax-free, and withdrawals for qualified medical expenses are tax-free. Unlike flexible spending accounts (FSAs), HSA funds roll over each year and remain portable when changing jobs. Financial planners emphasize their value as a retirement savings vehicle, especially given the high costs of healthcare in retirement, which can exceed $165,000 for a 65-year-old retiree.

3. Most HSA holders aren’t investing their funds despite widespread access to investment options: Although about two-thirds of employers offered HSA investment options in 2024, only 18% of participants took advantage of them, with the majority still using HSAs to pay for current medical expenses. Experts note that more participants could benefit from treating HSAs as long-term investment accounts to better prepare for future healthcare costs.

Payers ranked by Q1 profits

By Jakob Emerson - The nation’s largest payers have filed their first-quarter earnings reports, revealing which recorded the largest profits in the first three months of 2025. Read Full Article…

HVBA Article Summary

1. UnitedHealth Group Tops Industry Profits with $6.3 Billion in Q1 Net Earnings: UnitedHealth Group reported nearly $6.3 billion in net earnings for the first quarter of the year, driven by $5.2 billion in operating earnings from its UnitedHealthcare division, reinforcing its position as the most profitable U.S. health insurer.

2. Elevance Health and CVS Health Report Strong Quarterly Gains Led by Insurance Divisions: Elevance Health posted $2.2 billion in Q1 net income while CVS Health earned $1.8 billion, with both companies’ insurance businesses—Elevance’s health insurance operations and CVS’s Aetna division—contributing close to $2 billion each in operating income, signaling continued stability and growth across their core health insurance segments.

3. Cigna, Centene, and Humana Deliver Solid Profits Amid Insurance Segment Strength: Cigna Group and Centene each reported $1.3 billion in Q1 net income, with Cigna Healthcare generating nearly $1.3 billion in adjusted operating income; Humana followed with $1.2 billion in net income and $1.6 billion in insurance operating income, highlighting solid financial performance across these insurers’ health plans in a competitive market.

Aetna to exit health insurance exchange, leaving millions without coverage

By Ryan Benk and Ayesha Rascoe - You may know the name CVS because of their pharmacy business, but the health giant has a lot more under its umbrella, including clinics and the health insurer Aetna. Aetna is one of the largest health insurance companies in the country, but starting next year, around 1 million of its members will need new coverage. That's because the parent company, CVS, has said it will exit the Affordable Care Act Health Insurance Exchange, or Obamacare. Bruce Japsen is a senior contributor for Forbes, and he broke the story. Bruce, welcome to the program. Read Full Article… 

HVBA Article Summary

1. Aetna is exiting ACA exchanges amid financial and political uncertainty: CVS, Aetna’s parent company, is pulling Aetna out of Affordable Care Act (ACA) marketplaces partly due to broader financial pressures and uncertainty over whether Congress will renew enhanced subsidies that help make coverage more affordable.

2. The exit may reduce options and raise costs for consumers: Aetna’s departure could leave fewer choices for consumers in affected markets, potentially forcing enrollees to switch doctors or pay higher premiums if enhanced subsidies expire, especially for middle-income individuals who currently qualify for assistance.

3. Legal challenges and regulatory scrutiny add to business risks: CVS and Aetna are also facing a Department of Justice lawsuit over alleged Medicare Advantage kickbacks, raising questions about whether legal and regulatory costs are influencing strategic decisions like withdrawing from ACA exchanges.

CMS sets up real-time medical fraud center with DOGE; Federal contractor rolls out commercial tool

By Noah Tong - The Centers for Medicare & Medicaid Services (CMS) has launched the Fraud Detection Operation Center (FDOC) to fight waste, fraud and abuse, the agency announced this week. Listed on a new webpage are a list of “recent success stories.” They include taking action against improper enrollment in Affordable Care Act (ACA) plans, cracking down on false billing of wound care services and scrutinizing “problematic activities” regarding hospice claims. Read Full Article… 

HVBA Article Summary

1. CMS expands fraud detection efforts with new tools and real-time monitoring: The Centers for Medicare & Medicaid Services (CMS) launched the Fraud War Room and leveraged the Fraud Prevention System (FPS), powered by Peraton’s AI and machine learning models, leading to $43 million in suspended payments and the removal of 18 convicted providers while saving the government $13 billion over the past decade.

2. Peraton introduces Rapid Fraud Intelligence (Rapid FI) to accelerate investigations: Rapid FI, a new Peraton product, offers a faster, more intuitive interface for fraud detection by flagging suspicious provider activity based on metrics like billing patterns, patient distance, and social network analysis, aiming to pause payments before they are made and reduce costly “pay and chase” investigations.

3. Broader anti-fraud initiatives target systemic waste and abuse: In addition to technology-driven fraud detection, CMS is pursuing policy reforms such as shortening enrollment periods, ending certain Medicaid funding matches, tightening Medicare Advantage appeals, and cutting funding for ACA navigators, as part of a wider effort to clamp down on waste, fraud, and abuse in federal healthcare programs.

House bill would let patients buy drugs from non-U.S. pharmacies

By Allison Bell - A new House bill could help workers buy drugs from pharmacies in places like Canada, Switzerland, the United Kingdom and countries in the European Union. Rep. Janice Schawkowsky, D-Ill., introduced the bill, the Affordable and Safe Prescription Drug Importation Act, together with five Democratic cosponsors. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Proposed Bill Would Permit Drug Imports from Certified Foreign Pharmacies: The legislation would require the U.S. Department of Health and Human Services to establish a list of non-U.S. pharmacies that comply with standards comparable to those of U.S. pharmacies, enabling American patients to legally purchase lower-cost medications—including insulin, other injectable drugs, and pills—from these certified international pharmacies, while explicitly excluding compounded drugs, controlled substances, and inhaled anesthetics used in surgery.

2. Political Hurdles Likely to Block Passage in Current Congress: Although the bill has garnered support from groups like the Campaign for Personal Prescription Importation and aims to reduce high U.S. drug prices, its path forward is uncertain; with no Republican cosponsors and Republicans controlling both chambers of Congress, the bill faces slim chances of advancing beyond the House Energy and Commerce Committee, similar to a comparable measure that died in committee in 2024.

3. Trump Administration May Advance Importation Independently: While pharmaceutical manufacturers are likely to push back against broader importation efforts, the Trump administration has signaled a willingness to pursue policies that lower drug costs by easing import restrictions—including approval of Florida’s Canadian drug import program and directing HHS to explore additional options—raising the possibility that administrative action could expand access despite legislative gridlock.

What to Eat When You're Living With Long COVID

By Jasmine Laws - With the many debilitating symptoms of long COVID, diet often takes a backseat to medication or supplements. However, "the [COVID-19] virus activates your whole immune system, and we have most of our immune system housed in the gut, so what we eat really does matter," Lily Spechler, a registered dietician in Vermont who works with long COVID patients and has the condition herself, told Newsweek. Read Full Article…

HVBA Article Summary

1. Long COVID Causes Persistent Symptoms Across Patient Populations: Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), refers to lingering or new symptoms—such as fatigue, brain fog, shortness of breath, and joint pain—that last weeks or months after infection, affecting individuals regardless of the severity of their initial COVID-19 illness.

2. Caloric Deficits Common Among Long COVID Patients Despite Elevated Energy Needs: Many long COVID patients fail to consume enough calories to meet increased metabolic demands from symptoms like breathlessness and inflammation, prompting experts to recommend using a Total Daily Energy Expenditure (TDEE) calculator and boosting intake by 10–15% to support recovery.

3. Balanced Nutrition Key to Long COVID Recovery Through Protein, Fiber, and Omega-3s: Experts advise a personalized diet emphasizing protein for muscle repair, fiber and potassium for gut and vascular health, and healthy fats like omega-3s to aid nervous system function, while limiting caffeine after noon and alcohol before bedtime to promote healing and resilience.