Launching 2028 Estimates; Keeping Numbers Conservative but Optimistic on Upside from Pricing Cycle Recovery

Research evidence excerpt

Launching 2028 Estimates; Keeping Numbers Conservative but Optimistic on Upside from Pricing Cycle Recovery

May 20, 2026

1.7% at MOH, 1% at UNH and slightly positive at ELV.

2027 hosts another deck of changes for marketplace payors, but

we see them as manageable. The 2027 Marketplace Final Rule

1) allows insurers to offer catastrophic plans, 2) permits health

plans with no provider networks, 3) rescinds a requirement that a

state setting up a new exchange operates as a hybrid federal-state

marketplace, 4) tightens marketing standards and 5) reduces user

fees. We ultimately view the broader allowance of catastrophic plans

as this administration's path towards lowering premiums as it is far

too late into its second term for an overhaul of healthcare policy.

By 2028, we believe the Marketplace underwriting environment may

have substantially eased. Disruption over 2025 acuity shifts & 2026

bids have prompted market exits (e.g., CVS, CI) in tandem with

political risk at all-time highs. Our 2028 estimates do not embed that

the marketplace environment returns to HSD margins, but we believe

that the 5-7.5% range by this time frame is feasible.

●Commercial Group: Our 2028 outlook assumes that commercial group

trends remain elevated but stable with no major shifts in share. Our

2026 Benefit Manager Survey was early in suggesting that the 2026

commercial pricing environment is rational with a positive price to cost

spread & it did not suggest this was on the brink of shifting. It showed

that mental is the largest area of planned benefit expansion over the

next 3 years & did not indicate robust GLP-1 adoption by 2028. Early

2027 selling season commentary from payors remains strong & agrees

with our survey that drastic shifts in employer behavior are not a visibly

feasible outcome.