Market segment outlook : US health insurance

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<title>Market segment outlook</title>
<subTitle>: US health insurance</subTitle>
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<namePart>A.M. Best Company</namePart>
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<place>
<placeTerm type="code" authority="marccountry">usa</placeTerm>
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<dateIssued encoding="marc">2024</dateIssued>
<issuance>monographic</issuance>
<place>
<placeTerm type="text">New Jersey</placeTerm>
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<publisher>A.M. Best Company Inc</publisher>
<dateIssued>2025</dateIssued>
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<abstract displayLabel="Summary">AM Best has revised its outlook for the U.S. health insurance industry from Stable to Negative due to rising medical trends in Medicare Advantage, mismatches in rates and patient acuity in Managed Medicaid, increased utilization and claims costs in the commercial sector, and growing legislative and regulatory concerns. Despite these challenges, strong capitalization, liquidity, and continued favorable net investment income provide some offsetting support. The report highlights that medical costs, utilization, and morbidity are increasing across various lines of business, with operating margins under significant pressure in government programs and notably narrowing in the commercial market</abstract>
<tableOfContents displayLabel="Contents">Increased medical trend -- The medicare segment remains challenged -- Rate mismatch impacting managed medicaid -- Commercial group earnings deterioration -- Individual business shows material weakening of earnings -- Risk -adjusted capitalization, liquidity and investment performance -- Corrective action</tableOfContents>
<note type="statement of responsibility">A.M. Best Company Inc</note>
<subject xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="MAPA20080586294">
<topic>Mercado de seguros</topic>
</subject>
<subject xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="MAPA20080573867">
<topic>Seguro de salud</topic>
</subject>
<subject xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="MAPA20080548117">
<topic>Medicare</topic>
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<subject xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="MAPA20080548100">
<topic>Medicaid</topic>
</subject>
<subject xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="MAPA20080588953">
<topic>Análisis de riesgos</topic>
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<subject xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="MAPA20080611880">
<topic>Perspectivas del seguro</topic>
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<subject authority="lcshac" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="MAPA20080638337">
<geographic>Estados Unidos</geographic>
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<classification authority="">344.1</classification>
<relatedItem type="series">
<titleInfo>
<title>Best's market segment report</title>
<partNumber>August 25, 2025</partNumber>
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<recordCreationDate encoding="marc">250919</recordCreationDate>
<recordChangeDate encoding="iso8601">20250922100057.0</recordChangeDate>
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