Key Takeaways UnitedHealth's cost ratio averaged 87.1% in 1H25 and may near 89.4% by year-end, eroding margins.EPS outlook was slashed to at least $16, with earnings growth unlikely before 2026.Berkshire's 5M-share purchase fueled buying, but UNH still trades 39.7% lower year to date.UnitedHealth Group Incorporated (UNH) remains under heavy pressure after severely underestimating medical cost trends, a misstep that has eroded margins and rattled investors. Management has admitted to the problem, with expens ...

Core Insights - Elevance Health, Inc. is facing challenges from rising medical costs, slower Medicaid recovery, and increased utilization, leading to a reduced outlook for 2025 [1][5] - The company reported a significant increase in benefits expenses and cost of products sold in the first half of the year [1] Financial Performance - Benefits expense surged nearly 18% to over $72 billion, while cost of products sold increased almost 19% to $10.3 billion [1] - The second-quarter benefit expense ratio reached 88.9%, up 260 basis points year over year, with a projected full-year ratio of about 90% compared to 88.5% in 2024 [2][9] Membership and Growth - Commercial individual memberships rose 9.7% in the first half of 2025, following a 25.6% increase in 2024, indicating strong growth in the commercial segment [3][9] - Carelon's revenue is expected to grow nearly 30% in 2025, driven by a 60% surge in Carelon Services [4][9] Competitive Landscape - Other companies in the health benefits space, such as UnitedHealth Group and Centene Corporation, are also experiencing pressure from rising medical costs [6] - UnitedHealth's medical care ratio deteriorated to 89.4%, while Centene's health benefits ratio reached 93%, indicating industry-wide challenges [7] Valuation and Estimates - Elevance's shares have declined 20.7% year-to-date, compared to a 3.9% decline in the industry [8] - The forward price-to-earnings ratio for Elevance is 9.19, significantly lower than the industry average of 14.57, with a Zacks Consensus Estimate for 2025 earnings at $30.59 per share, reflecting a 7.4% decline from the previous year [10][11]

Core Insights - CVS Health's medical benefit ratio (MBR) improved to 87.3% in Q1 2025, a 310 basis point increase year over year, driven by favorable reserve development and stronger Medicare performance [1][9] - The company recorded a $431 million premium deficiency reserve (PDR) for expected losses in the individual exchange business, which will be exited in 2026, raising the MBR by approximately 130 basis points [1][9] - CVS anticipates a full-year MBR of approximately 91.3%, slightly better than its previous forecast of 91.5%, with expectations of stabilization in medical cost trends [4][9] Industry Trends - Elevated medical cost trends persisted across the industry, with major health insurers like UnitedHealth Group and Elevance Health experiencing similar dynamics [2][3] - UnitedHealth Group's medical care ratio rose by 50 basis points year over year to 84.8%, reflecting increased care activity in its Medicare Advantage business [2] - Elevance Health reported a benefit expense ratio of 86.4%, up 80 basis points year over year, primarily due to Medicaid rates not keeping pace with medical cost trends [3] Valuation and Performance - CVS Health shares have increased by 9.6% over the past year, contrasting with an 18.5% decline in the industry [7] - The company is trading at a forward 12-month price-to-earnings ratio of 10.12X, compared to the industry average of 14.60X, indicating a favorable valuation [8]