Managed Care Takeaways from Our ACA Exchange Actuary Call: Cautious Optimism in Early 2026, but Swing Factors Remain for 2027

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Managed Care Takeaways from Our ACA Exchange Actuary Call: Cautious Optimism in Early 2026, but Swing Factors Remain for 2027

J P M O R G A N North America Equity Research

24 June 2026

Managed Care

Takeaways from Our ACA Exchange Actuary Call:

Cautious Optimism in Early 2026, but Swing Factors

Remain for 2027

We hosted David Axene, FSA, CERA, MAAA, FCA (actuary and founder of Managed Care and Facilities

ACAxene Health Partners) for a wide-ranging discussion on the state of the ACA John Stansel, CFA

Exchanges in 2026 and beyond. We think commentary on the call pointed to early (1-212) 622-0083

2026 results being in the “better-than-feared” category for payors, with several key john.stansel@jpmorgan.com

factors to watch, such as a focus on lower-income enrollment in the ACA Lisa C. Gill

Exchanges, and an expectation for elevated trend. To that end, while payors across (1-212) 622-6466

the spectrum might be seeing early 2026 data favorable vs. expectations lisa.c.gill@jpmorgan.com

(consistent with commentary/expectations to date), we believe that, given the Benjamin Rossi

dynamic backdrop expected to continue for the foreseeable future, our coverage (1-212) 622-9603

benjamin.rossi@jpmorgan.com

will remain focused on prioritizing margins over membership. This matters, as we

Cole Harrissee most MCOs operating below target margins in 2026 and repricing further in

(1-212) 622-9068

2027. We believe the conversation supported the thesis we have proposed in the cole.harris@jpmorgan.com

past that the Exchanges could contract in 2027 as payors likely require premium J.P. Morgan Securities LLC

increases to account for a potentially worsening risk pool. We expect the next ACA

Exchange-related catalyst for MCOs will be commentary that provides