New York, January 13, 2026, 12:11 EST — Regular session
- UnitedHealth shares dropped roughly 1.3% mid-session amid increased Washington scrutiny on Medicare Advantage risk adjustment
- A Senate Judiciary Committee report accused the insurer of “gaming the system,” a claim UnitedHealth denied.
- Investors are turning their attention to UnitedHealth’s January 27 earnings and 2026 forecast, searching for signs of pressure on medical costs or shifts in policy assumptions
Shares of UnitedHealth Group Incorporated dropped roughly 1.3%, hitting $336.10 by midday Tuesday. The move came after a Senate Judiciary Committee report criticized the insurer’s Medicare Advantage risk-adjustment coding. Senator Chuck Grassley, who chairs the panel, claimed the company “appears to be gaming the system” related to payments for sicker patients. grassley.senate.gov
Why it matters now: Medicare Advantage channels a massive flow of public funds through private insurers, and any shift in payment formulas can come fast if Washington clamps down with stricter rules or ramps up audits.
Risk adjustment basically boosts Medicare Advantage payments when patients show costly conditions. The question is whether insurers are uncovering real, overlooked illnesses or just dialing up diagnoses to hike their payouts.
The Grassley-led report accused UnitedHealth of submitting more diagnoses and diagnosis codes than any other Medicare Advantage provider, leading to higher government payments compared to its competitors. The report described the company’s approach as turning risk adjustment into a “major profit centered strategy.” UnitedHealth countered, disputing the committee’s portrayal of its coding practices and HouseCalls program. The company insisted, “Our programs comply with applicable requirements,” noting that audits have consistently confirmed compliance with regulatory standards. Reuters
UnitedHealth revealed in an SEC filing that senior management is set to meet investors on Monday, aiming to reaffirm its previously announced adjusted 2025 earnings-per-share guidance. The company warned, however, that year-end closing procedures remain unfinished, and final results could still shift.
UnitedHealth revised its 2025 outlook in late October, boosting its full-year adjusted earnings forecast to at least $16.25 per share. “We remain focused on strengthening performance and positioning for durable and accelerating growth in 2026 and beyond,” CEO Stephen Hemsley said then. UnitedHealth Group
Some analysts downplayed the Senate report, treating it as an existing overhang instead of a fresh jolt. Bernstein’s Lance Wilkes described it as “not new news” and said it’s “largely reflected in these stock prices.” He did warn, however, that audits and investigations could still bring a $1 billion to $3 billion hit. Investing.com
UnitedHealth doubled down on Medicare Advantage’s cost benefits this week, highlighting two Milliman actuarial studies based on 2025 projections. According to the company, the reports show Medicare Advantage runs about 9% cheaper for the federal government compared to traditional Medicare and can reduce out-of-pocket expenses for some beneficiaries. The company also flagged CMS’s rollout of the V28 risk model as a potential drag on plan revenue.
On Tuesday, Humana dipped roughly 0.3% in the managed-care sector, with Elevance dropping around 1.1%. CVS held steady, while Cigna slipped about 1.5%. The Health Care Select Sector SPDR Fund edged down about 0.3%, roughly in line with the flat S&P 500.
UnitedHealth faces the risk that Senate scrutiny could escalate into concrete measures: stricter payment rules, intensified audits, or enforcement actions that squeeze cash flow and push for more cautious 2026 guidance. Even if no fresh penalties emerge, investors will be alert for any sign the company is pulling back on coding practices, which could weigh on near-term revenue or drive up medical expenses.
UnitedHealth is set to release its full-year 2025 results and 2026 outlook on January 27, before the market opens. A conference call will follow at 8 a.m. ET. Investors will be focused on management’s comments regarding Medicare Advantage risk adjustment, medical cost trends, and the potential effects of ongoing policy scrutiny.
