UnitedHealth's Q3 Beat Isn't Stopping the Bleed: Hold or Fold Now?

Core Insights - UnitedHealth Group Incorporated (UNH) has experienced a 9.6% decline in stock price following its third-quarter 2025 results, despite beating earnings expectations and raising its full-year outlook, primarily due to ongoing concerns about margin pressure [1][2][8] Financial Performance - Revenues for Q3 2025 increased by 12% year-over-year to $113.2 billion, narrowly missing consensus estimates by 0.2% [2][8] - Adjusted earnings per share (EPS) were $2.92, exceeding expectations by 6.2%, but reflecting a significant 59.2% decline from the same quarter last year, raising investor concerns about contracting margins [2][8] - The medical care ratio (MCR) rose to 89.9% in Q3 2025, indicating increased costs and further straining profit margins [8][17] Management Outlook - Management remains optimistic about margin recovery in 2026, having repriced most risk-based businesses, although Medicaid is expected to face ongoing challenges [3][4] - Medicare Advantage membership is projected to decline by approximately one million members in the upcoming year due to plan adjustments [4] - The company anticipates a 67% drop in Affordable Care Act enrollment, primarily due to unsustainable rate structures [5] Market Position and Challenges - UnitedHealth's stock has dropped 34.6% year-to-date, underperforming compared to the industry average decline of 29% and contrasting sharply with the S&P 500's 18.1% increase [12] - The stock trades at a forward price-to-earnings (P/E) ratio of 18.98X, above the industry average of 15.29X, indicating it is not currently a bargain compared to peers [14] - Regulatory and legal challenges persist, including investigations into Medicare billing practices and potential impacts from the "most-favored nation" executive order [18][19] Long-Term Perspective - Despite current challenges, UnitedHealth's scale, diversification, and customer base provide resilience, with management taking steps to restore stability [20] - U.S. healthcare spending is expected to rise, driven by an aging population and chronic diseases, which may favor integrated players like UnitedHealth [21] - The company has maintained a disciplined approach to shareholder returns, distributing $5.9 billion in dividends and executing $5.5 billion in buybacks in the first nine months of 2025 [22]