http://www.beckershospitalreview.com/payer-issues/fitch-health-insurer-credit-metrics-hit-hard-in-first-half-of-2016.html

Higher leverage ratios from acquisition-related debt combined with declining revenue growth and declining interest coverage ratios contributed to deteriorating credit metrics for publicly traded health insurers in the first half of 2016, according to a Fitch Ratings report.

The weakened credit picture has led Fitch to take several negative rating actions. The rating agency downgraded Louisville, Ky.-based Humana’s senior notes, revised Minnetonka, Minn.-based UnitedHealth Group’s rating outlook to negative and placed ratings of Hartford, Conn.-based Aetna, Indianapolis-based Anthem and St. Louis-based Centene on negative watch.