Q1 2026 managed care earnings looked like a recovery. They were not. Here is what actually happened across UHC, CVS, Elevance, Humana, Centene, and Molina.
Cost trend did not reverse. Hospital costs are still up. Senior utilization is still elevated. Specialty drug spend is still ugly. Plans just stopped waiting for the trend to fix itself.
What changed: benefit design tightened, networks narrowed, prior auth volume rose, pharmacy controls got harder, and entire product lines and counties got exited. Less coverage, not cheaper care.
The Molina $96m impairment on its MA-PD exit is the clearest signal. The cheapest claim is the one that never enters the book. That logic is now running at every major plan.
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