A 9.5% 2027 increase would mark the fourth consecutive year of near–double-digit employer medical trend, based on data from 1,100+ employers covering 7.9 million employees.
Utilization growth, chronic-condition burden, and increased high-cost claim incidence are central contributors to accelerating plan spend across employer-sponsored coverage.
GLP-1 costs are rising as use extends beyond diabetes/obesity into cardiovascular disease, sleep apnea, and CKD, with oral options expanding eligibility and limiting employer cost-containment.
Employers funded ~82% of total plan costs in 2026, yet employees still paid $5,297 on average, driven by a 10.2% out-of-pocket increase and leaner plan designs.
Industry variation is material, with 2025–2026 employer cost growth ranging from 6.5% (health care) to 9.8% (finance/insurance), echoing KFF and Mercer trend warnings.
Aon projects a fourth straight year of near double-digit health cost growth for U.S. employers, with 2027 costs set to top $19,000 per worker.
Employer health care costs in the United States may rise 9.5% in 2027, extending a fourth consecutive year of near double-digit increases the longest such stretch since 2007, according to a recent analysis by Aon.
Employer healthcare costs could rise 9.5% in 2027, pushing the average per-employee price tag past $19,000, according to a recent analysis by the consulting firm Aon. If this happens, it will be the fourth year running that cost growth has approached double digits, a run Aon says is unmatched in its trend data since 2007. The company currently has data from more than 1,100 U.S. employers representing 7.9 million employees.
Behind the projected growth is a familiar mix of pressures, including climbing utilization of medical services, a growing share of members with chronic conditions, and more high-cost claims moving through employer plans. Specialty and GLP-1 drug spending adds another layer, which is growing as GLP-1s move beyond diabetes and weight management into cardiovascular disease, sleep apnea and chronic kidney disease. New oral formulations are widening the pool of patients who can access the drugs, which cuts against employers’ efforts to hold the line on pharmacy spend. Aon also flagged providers’ use of AI tools for clinical documentation and coding, which the firm says is contributing to higher billed charges in some cases.
“The organizations best positioned for the future will be those that can proactively identify emerging risks and take targeted action before costs escalate,” Debbie Ashford, North America Chief Actuary, Health Solutions for Aon, also said in the news release. “Health care costs are becoming increasingly difficult to manage through traditional approaches alone. Employers will need better data and deeper insights to understand where costs are rising and how they can make more informed decisions about their health care investments.”
Who absorbs the increase?
Employer health plans don’t pass every dollar of that growth on to workers. Aon’s data shows employers picked up approximately 82% of total plan costs in 2026, a share that’s held roughly steady even as the underlying cost trend accelerated. Employer costs more than doubled from 2022 to 2026: climbing from 3.7% to 8.8% in 2026, respectively.
Employees still felt it. The average worker paid $5,297 toward health care in 2026, split between $3,130 in payroll premium contributions and $2,167 in out-of-pocket spending, up from $4,909 the year before. The out-of-pocket piece grew faster than premiums, up 10.2%, which Aon attributes to both higher utilization and a shift toward leaner plan designs with more member cost-sharing built in.
The picture isn’t uniform across sectors. Aon’s industry breakdown shows a wide spread in how much employer costs grew from 2025 to 2026:
Finance and Insurance: 9.8%
Technology and Communications: 9.1%
Public Sector: 8.8%
Professional Services: 8.7%
Retail and Wholesale Trade: 7.7%
Manufacturing: 7.5%
Health Care: 6.5%
How this compares across the industry
Aon’s numbers land alongside other recent industry data pointing the same direction. KFF’s benchmark survey of employer health benefits found family premiums rose 6% in 2025 to reach nearly $27,000, a jump the group said outpaced general inflation by a wide margin. KFF has separately flagged early signals that 2026 cost trends would run even higher. Mercer and the International Foundation of Employee Benefit Plans have published similar warnings over the past year, with some industry surveys describing the coming increase as among the largest employers have faced in over a decade.
“Employers have now experienced several consecutive years of health care cost increases that are approaching double digits,” Mike Pasterick, North America Health Solutions Leader for Aon, said in the news release. “At this level, rising health care costs become much more than a budgeting challenge and influence organizational decisions from benefits strategy and employee affordability to broader workforce and financial planning priorities.”
New STAT reporting reveals the IRS is seeking back taxes from UnitedHealth Group over foreign subsidiary transactions — adding to the conglomerate’s growing list of federal headaches.
According to STAT, the IRS is “seeking to significantly increase taxable income” reported by the company during those four years, and the dispute could extend to tax years after 2020. UnitedHealth disclosed in a recent regulatory filing that it received notices from the IRS in March.
The piece notes that this is not a routine tax audit. Investigations like this (involving what is known as “intercompany transfer pricing”) are exceedingly rare and typically examine how large multinational corporations allocate profits and expenses among subsidiaries in different countries. Which could lead one to assume there is a significant amount of money involved.
UnitedHealth disputes the IRS’ findings and says it intends to “vigorously contest” the proposed adjustments. It is not yet known which of the company’s many foreign subsidiaries is involved.
Herman also got an unusual glimpse behind the curtain: STAT was copied on internal emails about how UnitedHealth should respond to his questions, including one in which spokesperson Tyler Mason said he left out an explanation for withholding IRS documents because it “sounded too defensive.”
A bit about UnitedHealth Group’s international operations
Last year, the Center for Health & Democracy released the Sunlight Report on UnitedHealth Group which documented – for the first time – 2,694 subsidiaries and affiliated entities tied to the health care titan. That vast corporate structure shows that UnitedHealth has become so much more than the insurance company folks recognize from a card in their wallet. These days, through its subsidiaries UnitedHealthcare and Optum, this giant corporation’s reach stretches far beyond traditional health insurance. It has branched into physician practices, pharmacies, pharmacy benefit management, data analytics and numerous other corners of the health care system – and the world – with more than 150 international entities in the Sunlight Report’s tally.
And many of UnitedHealth’s international entities, as of late, have become thorns in the company’s side.
Last summer, HEALTH CARE un-covered wrote about the company’s desire to unload its subsidiary Banmédica (a Latin American health insurer and health care provider that operates hospitals and medical centers) after it racked up more than $8 billion in losses and pressures at home mounted. By November 2025, UnitedHealth had struck a roughly $1 billion deal to sell Banmédica to a Brazilian private equity firm.
UnitedHealth Group, the behemoth health insurer that has steadily transformed itself into a global health care conglomerate, is now looking to offload part of that empire to appease shareholders.
While that deal has continued moving toward completion, the latest we know is that the agreement is still awaiting final regulatory approval. There is no indication that Banmédica is the foreign subsidiary at the center of the IRS investigation but the two stories underscore the sheer complexity of UnitedHealth’s corporate structure and global reach.
IRS scrutiny, under this context
Financially, at least, the company appears to have regained its footing after one of the most turbulent stretches in its history. It wowed Wall Street when it announced that its profits increased a whopping 55% during the second quarter of 2026, from $5.2 billion at the end of 2Q 2025 to $8 billion in 2Q 2026. That puts the company on track to post profits for the year north of $30 billion.
But quarterly success is not the full picture. Make no mistake, UnitedHealth already had some very real problems behind the scenes — and that’s before this latest IRS situation:
OptumRx and Optum doctors Bloomberg reported last year that the Justice Department’s criminal investigation had broadened to examine business practices at OptumRx,the company’s massive pharmacy benefit manager, as well as how the company reimburses physicians employed by its own Optum businesses.
Insulin prices OptumRx is also facing a separate challenge from the Federal Trade Commission, which accused it and the country’s other two dominant pharmacy benefit managers of using rebate practices that artificially inflated insulin list prices. That case appears to be nearing a resolution: the FTC withdrew the case against Optum from adjudication in June to consider a proposed consent agreement. OptumRx is still without a finalized deal.
None of these investigations or allegations establishes that UnitedHealth broke the law, and the company has disputed allegations of wrongdoing.
But taken together, they make for quite a contrast. UnitedHealth and its web of subsidiaries just reported another multibillion-dollar quarter at the same time that federal authorities are essentially digging through its trash — from its Medicare Advantage business and pharmacy benefit operations to, now, how it may have moved money through a foreign subsidiary for tax purposes.
P.S. — UnitedHealth Group and baseball
Last Saturday, while watching the Phillies take on the Minnesota Twins (Phillies won 9–1. Go Phils!) I (Joey) couldn’t help but notice the UnitedHealthcare-branded cushions lining the seats behind home plate. UnitedHealthcare, for those keeping track of the corporate family tree, is the health insurance subsidiary of UnitedHealth Group. UnitedHealthcare is commonly abbreviated as UHC (that’s what was on the seat cushions), while its parent company, UnitedHealth Group, is often shortened to UNH, its stock ticker.
And the joke I’m trying to make here is pretty simple: There’s no escaping UnitedHealth’s reach… not even at a baseball game!🥁
The game was at Target Field in Minneapolis, and Minnesota-based UnitedHealth Group, through its UnitedHealthcare subsidiary, has a longstanding partnership with the Twins. So while the Phillies were busy routing Minnesota on the field, UnitedHealth Group was getting plenty of airtime behind their hometown home plate. (Our premium dollars at work!)
Hospital CEO turnover remained above last year’s pace through the first half of 2026 even as departures across industries decreased, continuing a trend that emerged earlier this year.
KEY TAKEAWAYS
While CEO departures across U.S. companies fell 26% during the first half of 2026, hospitals recorded an 8% increase, making healthcare one of the few sectors still experiencing elevated leadership turnover.
Increased hospital CEO exits during the first quarter carried into the first half of 2026, suggesting the rise in turnover has become more sustained.
As leadership changes continue at a higher rate than in most industries, hospital boards face greater pressure to strengthen executive pipelines and preserve continuity.
The wave of CEO departures that hit corporate America over the past two years has largely stabilized. Hospitals, however, continue to move in the other direction.
A report from Challenger, Gray & Christmas found U.S. companies announced 920 CEO exits during the first half of 2026, down 26% from 1,235 departures during the same period last year, while hospitals recorded 74 CEO exits through June, compared to 68 during the first half of 2025, for an increase of more than 8%.
The contrast suggests the spike in hospital leadership turnover that emerged during the first quarter has extended into a larger trend.
For June, hospitals announced 10 CEO departures, down from 17 during the same month last year. Earlier months produced increased activity, with 16 exits in March, 16 in April, and 14 in May.
Most other sectors, conversely, have experienced significant year-over-year declines in CEO turnover. Government/not-profit, which has announced the most exits over the past two years, saw departures drop from 256 through the first half of 2025 to 247 through June 2026.
The industries that also dealt with an uptick in year-to-date turnover were aerospace/defense (13 in 2026, eight in 2025), insurance (20, 17), media (15, 12), and pharmaceutical (22, 17), with none of those sectors coming close to the volume seen with hospitals.
The data reveals how much of an outlier hospital CEO turnover has been and the effect that financial pressures, workforce challenges, and policy changes have had on executive leadership.
For hospital boards, persistent and elevated turnover increases the importance of succession planning as a priority rather than a contingency.
Now and going forward, boards may place greater emphasis on developing internal leadership pipelines and maintaining continuity during executive changes.
“Boards continue to hold onto the leaders they have rather than reaching for change, and the first-half pace now sits a full quarter below last year,” Andy Challenger, labor expert and chief revenue officer for Challenger, Gray & Christmas, said in a statement. “After two years of elevated turnover, companies are prioritizing stability.”
New National Health Expenditure projections show sustained cost growth outpacing GDP, driven by Medicare expansion, rising drug spend, and persistent utilization pressures.
KEY TAKEAWAYS
Medicare is projected to grow faster than other payers, increasing exposure to lower reimbursement rates and tightening system-wide margins.
Utilization is driving costs. Post-pandemic service use remains elevated, undermining the assumptions that demand would normalize.
Rapid pharmaceutical growth and shifting federal pricing policy make pharmacy costs unpredictable and scenario-dependent.
The latest National Health Expenditure projections from Health Affairs and CMS confirm what CFOs already suspect: cost growth is structural. Total U.S. health spending is expected to grow at roughly 5.4% annually through 2034, consistently outpacing GDP growth of about 4.1%, pushing healthcare’s share of the economy from roughly 18% today to more than 20% by 2034.
The first major implication is funding-source imbalance. Medicare is projected to grow the fastest at roughly 7.7% annually, driven by demographics and utilization intensity. Medicaid and commercial insurance trail at about 5% each, but still above general inflation. This divergence matters. Payer mix will steadily tilt toward government payers with structurally lower reimbursement growth. Even small shifts in payer composition will exacerbate pressure on operating margins unless productivity gains or rate improvements offset them.
Secondly, utilization is what’s really driving the next wave of cost growth. Recent data show elevated service use across hospital, physician, and pharmaceutical categories, with little evidence that post-pandemic demand has normalized. That suggests budgeting cycles can no longer assume regression to pre-2020 utilization trends. For CFOs, this complicates volume forecasting: demand is becoming less predictable and more sensitive to coverage expansion and policy-driven enrollment changes.
Third, prescription drug spending is now the fastest-growing category, with retail pharmaceuticals set to outpace hospital and physician services through the projection window. The combination of specialty drug uptake and policy-driven price reforms creates a dual volatility problem: higher baseline spend alongside uncertain future savings from federal negotiations and benefit redesigns. CFOs in both provider and payer organizations should treat pharmacy cost projections as scenario-driven, not point estimates.
Fourth, federal policy is increasingly the dominant driver of revenue exposure. The federal government’s share of total health spending is expected to rise from roughly 31% to 33% by 2034, reinforcing dependence on Medicare and federal Medicaid financing. At the same time, policy volatility—particularly around subsidies, eligibility rules, and drug pricing—introduces new forecasting risk that cannot be diversified away. CFOs should expect more frequent mid-cycle reimbursement adjustments and greater lag between policy adoption and financial realization.
Fifth, the insured population is expected to slightly decline as a share of total population over the next decade. This is a subtle but important signal for providers, because even small coverage shifts can disproportionately affect elective volume, bad debt exposure, and charity care assumptions. CFOs should incorporate coverage elasticity into long-range planning models, especially in markets with high exchange enrollment sensitivity.
Finally, healthcare is steadily absorbing a larger share of the U.S. GDP. Look out for structural revenue tailwinds for the sector and intensifying political and payer pressure to contain costs. CFOs should expect sustained scrutiny on operating efficiency, administrative overhead, and price justification across all service lines.
Ultimately, the shift here is from static 10-year budgeting to dynamic scenario planning. Health systems that quickly model policy sensitivity, payer mix drift, and utilization volatility in real time will be better positioned than those relying on historical cost curves that just no longer hold up.
At least 568 healthcare facilities operate through nonprofit-private equity joint ventures, according to a new report calling for scrutiny into those arrangements.
The figure is likely an undercount, considering only public data were used. The report (PDF) was published by the Private Equity Stakeholder Project (PESP), a nonprofit that advocates for more disclosure about private equity deals.
More than a fifth of private equity (PE)-owned hospitals operate under joint venture arrangements with nonprofit health systems.Apollo Global Management-owned Lifepoint Health, for instance, runs nearly two-thirds of its hospitals through joint ventures.
Such joint ventures extend beyond hospitals, spanning subsectors such as inpatient rehab, hospice, home health, behavioral health, ambulatory surgery centers and urgent care, per the report. And regulations have not kept up with these evolving complex ownership structures.
“While joint ventures may be advantageous configurations for the businesses involved, PE-backed joint ventures may still represent the risks associated with PE buyouts in healthcare,” the report said.
The report identified several patterns related to such arrangements. First, joint ventures with a provider offer an opportunity for a PE-backed company to expand into new markets. Joint ventures may also help companies get around regulatory restrictions, like in some states that forbid non-doctors from owning medical practices. It may help avoid the challenges associated with converting a health system from a nonprofit to a for-profit. Joint ventures also grant access to private capital and may drive revenue from the sale of real estate, a practice critics have said fueled high-profile health system bankruptcies in recent years.
One negative pattern, the report cautioned, is patient and caregiver risks due to poor facility conditions, declining care quality, reduced services and higher prices. PESP gave as an example Lifepoint’s involvement in Duke, where associated facilities have seen poor quality of care and have cut services. Lifepoint was the subject of a recent bipartisan Senate investigation, supported by other PESP research, which found underinvestment has affected patient care.
Another example worthy of caution, per the report, is Ascension, which, in addition to having a joint venture with Lifepoint, also works with PE firm TowerBrook Capital to acquire healthcare companies. This case study shows how executives and PE businesses make outsized profits from entering healthcare markets, despite clinician concerns about future negative impacts to patient care.
While much of the public and an increasing share of policymakers have been wary of PE’s involvement in healthcare due to these cases and others,proponents contend that funds can help fill in gaps where public funding for healthcare falls short, such as by supporting services in underserved areas or providing resources and managerial expertise that would otherwise be out of reach.
PESP’s report said the examples it documented “expose significant gaps in federal and state oversight of private equity in healthcare.”
To address this, PESP recommends that the IRS update its joint venture guidance; that the HHS Office of the Inspector General update its guidance on anti-kickback statutes; and that CMS clarify whether exceptions to Stark Law—which protects medical decisions from financial conflicts of interest—apply in PE-backed joint ventures. PESP also called on the Federal Trade Commission and the Department of Justice to better scrutinize joint ventures that don’t trigger individual premerger review, but still amass market influence.
Additionally, the report was accompanied by a public searchable database of 568 nonprofit-PE joint ventures as identified by PESP. The database is embedded on PESP’s site.
“Patients, payers and employees need protection from the risks associated with PE ownership of healthcare systems and joint ventures expose significant gaps in oversight and regulation,” the report concluded.
Health insurers love to talk about profit margins. But return on equity — the metric investors actually use—reveals an industry generating outsized returns.
When UnitedHealth Group reported its first-quarter 2026 results, it disclosed something that didn’t make many headlines: an annualized return on equity of 26.2%.
That number — not the profit or operating margin — is what Wall Street uses to evaluate whether a business is making good use of the money investors have put into it. And by that measure, UnitedHealth wasn’t just profitable, it was posting returns that outpace the broader S&P 500, dwarf most of its sector peers, and rival industries that Americans actually regard as highly lucrative.
So why do we keep hearing about margins?
Because margins are the health insurance industry’s favorite misdirection. And understanding the difference between the two figures is essential to understanding why the health insurance business is far more profitable — and far more extractive — than its lobbyists want you to know.
What Margin Actually Measures
Profit margin measures how many cents of profit a company keeps for every dollar of revenue that flows through it. For a health insurer, revenue is primarily premiums and fees — the massive river of money that employers, individuals, and government programs pour in every month to pay for coverage.
That river is enormous. In 2025, UnitedHealth took in $447.6 billion in revenue — nearly half a trillion dollars. A 5% margin on $447.6 billion is still a lot of profit. But when industry defenders cite the 5% figure, they’re counting on you to hear “five cents on the dollar” and think health insurers are not all that profitable.
(Note: In its first quarter 2026 earnings press release, the company reported that in the first quarter of 2026, its insurance division, UnitedHealthcare, had an operating margin of 6.6% and that Optum, the division that operates a huge PBM and hundreds of physician practices and other clinical operations across the country, had an operating margin of 5.1%. The press release didn’t even mention return on equity. You have to look at the company’s 10Q filing with the SEC to find the 26.2% ROE disclosure.)
I know this tactic well because I used it myself. During my nearly sixteen years at Cigna, where I was vice president of corporate communications, one of my standard moves was to cite the most recent margin figure when talking to journalists or writing talking points for our Washington lobbyists to use with members of Congress and their staff. It was technically accurate yet deeply misleading — exactly the combination that makes for effective spin. The goal was to create the impression that Cigna was a low-profit business barely keeping the lights on, when the return on equity told an entirely different story. I never brought up ROE and can’t recall a reporter asking about it.
What Return on Equity Actually Measures
Return on equity — ROE — measures how much profit a company generates relative to the money its shareholders have invested. It is essentially a report card on management’s ability to turn the money shareholders have invested into earnings. Investors and analysts use it to evaluate whether a business is creating or destroying value.
By this measure, UnitedHealth’s performance is striking:
Q1 2026: 26.2% annualized ROE
Full-year 2023: 27.0% ROE
Full-year 2022: 27.2% ROE
Even in 2025 — the year the Medicare Advantage cost crisis hammered earnings across the industry — UnitedHealth’s full-year ROE came in at 12.8%, which is still above the median for health care support services companies (roughly 9.9%, per the Stern NYU January 2026 sector database).
To put 26–27% in context: the S&P 500 long-run average ROE runs in the 14–18% range. The general and broader insurance sector average is around 19%. The health care support services sector average — the category that most directly captures managed care companies — sits at just under 10%. UnitedHealth, in its normal operating years, is generating returns nearly three times that sector median, making it one of the most capital-efficient, high-return enterprises in American corporate life.
How a Relatively Small Margin Becomes a Massive Return
Health insurers operate with enormous revenue bases relative to their equity. When a company takes in close to half a trillion dollars in revenue but only has around $100 billion in shareholders’ equity on its balance sheet, even a modest net margin generates a big return on the invested capital.
In the insurer’s case, the “borrowed” capital isn’t debt in the traditional sense — it’s the float. Premiums come in at the beginning of the month. Claims go out throughout the month and into the next. That gap — the time between collection and payment — allows insurers to invest billions in securities, real estate and other holdings, earning investment income on money that technically belongs to the people whose claims haven’t been paid yet. UnitedHealth consistently earns more than $1 billion in investment income every quarter. It made $1.1 billion on its investments in the first quarter of this year and $1.0 billion in the same quarter last year. In 2024, when the company made $34.4 billion in earnings from its operations, its investment income totaled $5.2 billion.
This means that the company’s business model compounds the ROE advantage at every level: high premium volume, leveraged equity base, investment float.
UnitedHealth’s ROE advantage is even clearer when you look across the sector. Humana — which has been savaged by Medicare Advantage losses and is now posting a last-twelve-months ROE of roughly 6.8% — shows what happens when the underlying business goes wrong. Elevance and Cigna, facing similar MA cost pressure through 2024 and 2025, have also seen their returns compress. (In a move that likely will boost ROE, Cigna last year sold all of its Medicare Advantage business.)
But here’s what’s important to understand about those compressed numbers: Not a single major insurer posted an actual loss for the full year 2024. As one observer noted, the investor panic of 2025 was triggered not by losses but by smaller profits than expected. Elevance’s stock dropped 20% in two days when the company announced it expected to earn $5.4 billion instead of $6.4 billion. In any other industry, $5.4 billion in annual profit would not be considered a crisis.
UnitedHealth’s annualized 2026 ROE of 26.2% — reported even as the company is under federal criminal investigation — suggests the underlying earnings machine remains intact beneath the turbulence.
What the Sector Data Actually Shows
The NYU Stern sector database, updated as of January 2026 using data across thousands of U.S. companies, puts the managed care picture in relief:
UnitedHealth’s historical 27% ROE places it at or near the top of all of these categories — not just its own sector, but across the American corporate economy (with the exception of some of the biggest tech companies, whose ROEs are consistently at the very top). The company that processes your prior authorization denial is generating returns that rival the most profitable financial services firms in the country and even has a greater return than most pharmaceutical companies.
A December 2025 analysis by Milliman, an actuarial firm, made explicit what the ROE data implies. Examining the spread between for-profit and nonprofit health insurers, the analysts found that for-profit companies hold less capital and surplus relative to their premium volume — and that this “additional leverage leads to an even higher return on equity than their nonprofit and not-for-profit counterparts.”
What that means is that for-profit insurers have engineered their balance sheets to maximize the return on every dollar of equity, using premium float and leverage, in ways that nonprofit plans structurally cannot replicate.
Why This Matters for Policymakers
The margin talking point is not merely misleading — it is strategically deployed to block reform.
When Congress considers capping insurer profits, or lowering Medicare Advantage overpayments, or modifying and strengthening the Affordable Care Act’s medical loss ratio requirements, the industry’s first move is to present itself as a low-margin business operating on thin ice.
The margin talking point says: don’t look at us, we’re barely getting by. The ROE data gives the lie to this. A company earning 26% on equity is not on thin ice. It is extracting premium value from the health care system at a rate that most American industries can only envy — and doing so while denying claims, managing risk scores, and fighting every form of regulatory oversight.
As major health systems accuse CVS Health of diverting hundreds of millions of dollars in 340B savings, the litigation highlights a broader challenge for hospital CFOs.
KEY TAKEAWAYS
Increasingly, 340B savings help offset Medicaid shortfalls and fund mission-driven services that operate at negative margins.
CFOs should evaluate whether existing PBM, specialty-pharmacy and contract-pharmacy agreements provide sufficient audit rights and data access.
Future financial risk may stem less from claims denials and more from opaque reimbursement methodologies, spread-pricing allegations and contract-performance issues embedded in complex pharmacy arrangements.
Three major health systems—including affiliates of the University of Michigan, Mount Sinai and the University of Kansas—have individually launched lawsuits against CVS Health alleging that the company and its subsidiaries diverted approximately $250 million in 340B drug-program savings through reimbursement practices that improperly retained funds intended for safety-net providers. The cases claim the alleged practices occurred between 2020 and 2025 and involved what plaintiffs describe as a concealed pricing arrangement that redirected 340B revenue away from hospitals.
However, the significance goes well beyond the courtroom.
The litigation underscores how dependent many health systems have become on supplemental revenue sources to offset chronic Medicaid underpayment and rising uncompensated care costs. The lawsuits arrive at a time when hospital margins remain fragile despite some post-pandemic stabilization, and when many organizations are increasingly reliant on pharmacy operations to support broader community-benefit and clinical programs.
A spokesperson for Mount Sinai commented:
“Several health care systems across the country, including Mount Sinai, have brought this lawsuit to ensure that the funds that are supposed to be available to mission-driven hospitals like Mount Sinai that serve a disproportionate share of the Medicaid and uninsured population, are not wrongly skimmed off by for profit intermediaries.”
According to the complaints, the hospitals estimate they lost more than half of the 340B savings they should have received during the period in question. One University of Michigan-related lawsuit alone alleges more than $66 million in lost revenue.
This lawsuit highlights that pharmacy revenue has shifted into a deep finance issue.
Historically, 340B was seen as a beneficial and fairly stable funding mechanism, but with the program sitting at the center of disputes involving manufacturers, pharmacy benefit managers (PBMs), contract pharmacies and regulators, are the complications outweighing its worth? The CVS litigation highlights the growing complexity of revenue flows within vertically integrated healthcare organizations, where PBMs, specialty pharmacies and insurers may all participate in a single transaction.
With hospitals already grappling with Medicaid reimbursement rates that often fail to cover the cost of care, any disruption in 340B revenue can create disproportional financial consequences. Since many systems use 340B-generated savings to subsidize behavioral health programs, oncology services, rural outreach, and care for uninsured populations. A material reduction in those funds can quickly translate into operating-budget pressure.
The lawsuits also reveal that CFOs are increasingly scrutinizing third-party contracts for revenue leakage. Several of the complaints allege that hospitals struggled to obtain underlying data needed to audit transactions and verify reimbursement methodologies. The plaintiffs claim requests for transparency and audits were resisted, limiting their ability to independently validate payment calculations.
That issue should resonate across the industry.
As payer-provider relationships become more complex, CFOs may need to devote greater resources to contract analytics, pharmacy revenue-cycle oversight, and independent auditing capabilities. Revenue integrity programs that traditionally focused on claims and denials management may need to expand deeper into 340B administration, PBM contracts, and specialty-pharmacy arrangements.
Whether the hospitals ultimately prevail remains uncertain. CVS has not publicly conceded the allegations, and the claims will be tested through litigation. But the cases reinforce a reality many CFOs already recognize: in an era of Medicaid pressure and thin operating margins, protecting every dollar of supplemental revenue has become crucial.
In Q1 2026, 7 Big Insurers did what their shareholders demanded: hike premiums, slash benefits and dump the sick.
The most recent numbers the nation’s largest for-profit health insurers have shared with investors tell a story the industry is eager to tell Wall Street: the worst is over. After two brutal years of earnings misses, executive firings, and stock price collapses driven by unexpectedly high medical spending, the seven biggest publicly traded health insurers have now completed their first-quarter earnings reports for 2026 and their shareholders are cheering.
Every one of them beat analysts’ expectations in various ways, and most raised their full-year 2026 guidance. But before you read the company-by-company results, it is worth examining the mechanisms behind that recovery because the story the earnings releases tell is not quite the same as the story they leave out.
To get back into Wall Street’s good graces, insurers have:
raised premiums
cut benefits
narrowed their provider networks
exited markets that weren’t meeting investors’ profit expectations, and
shed members they deemed too costly to cover.
Across the seven companies, total medical membership fell by roughly four million people between the first quarter of 2025 and the first quarter of 2026, and from what executives signaled to investors, many more people likely will be dumped by the end of the year. The patients who already have lost coverage through market exits or who found their benefits reduced this year do not appear as line items in an earnings release. They appear in the year-over-year membership declines and skimpier benefits that analysts note with approval.
In second episode of the HEALTH CARE un-covered Show, we walk you through the full year 2025 earnings reports of seven of the largest for-profit health insurance corporations in the country.
The key metric driving the recovery is the medical loss ratio — the percentage of premium revenue that insurers actually spend on medical care. When that number falls, profits rise and investors get richer. Across the sector, medical loss ratios came down in the first quarter, or at least came in lower than Wall Street feared. Insurers credited tighter cost management, a milder flu season, and “repricing” — the practice of raising premiums and cutting benefits, particularly in Medicare Advantage plans, to close the gap between what they collect and what they pay out. (Financial analysts’ term for this is benefit buydown, which is unique among American industries.) Higher revenue coupled with devalued benefits produces better medical loss ratios from investors’ perspective.
The stock market has responded — but the picture is more complicated than a simple sector rebound. Most of these stocks are up year to date, measured from deeply depressed December 31 baselines. But look back a full year and a different story emerges: four of the seven companies are still worth less today than they were a year ago. Molina is down 43% over that period. Cigna and Elevance are each down about 6%. The “recovery” is real in the sense that stocks have bounced off their bottoms.
For much of the sector, it is not yet a return to full health, but the companies clearly are making good on their assurances to investors that they will do whatever it takes to improve their profit margins, regardless of the consequences to patients.
Here is what each of the seven reported — and what each report left out.
UnitedHealth Group
UNH Close (May 11): $384.44 YTD: +17.4% 1-year: +4.4% Dec 31: $327.56 | May 12, 2025: $368.36
UnitedHealth Group, the nation’s largest health insurer, reported first-quarter 2026 revenues of $111.7 billion, with adjusted earnings of $7.23 per share and a medical loss ratio of 83.9% — well below the 85.5% analysts had expected. The company raised its full-year adjusted earnings guidance to more than $18.25 per share.
UnitedHealth attributed the year-over-year declinedecline in its medical loss ratio to strong medical cost management and favorable reserve development, while acknowledging “consistently elevated utilization and unit cost trends.” In plain terms: patients are still using more care than the company would prefer, but UnitedHealth is getting better at managing around it.
The stock’s 17% year-to-date gain requires context. UnitedHealth ended 2025 at $327.56 — the result of a punishing year that included the Change Healthcare cyberattack, the killing of its insurance CEO, and mounting federal scrutiny of its Medicare Advantage risk-scoring practices. Then this past January, a disappointing fourth-quarter 2025 earnings report sent shares plunging nearly 20% in a single session, pushing the stock to its recent lows before the partial recovery began to take hold. The May 11 close of $384.44 leaves the stock about 4% above where it was a year ago — a modest gain that reflects recovery from a deep hole rather than a return to anything resembling its former heights.
CVS Health / Aetna
CVS Close (May 11): $92.23 YTD: +18.2% 1-year: +47.5% Dec 31: $78.03 | May 12, 2025: $62.52
CVS Health reported first-quarter net income of more than $2.9 billion as costs slowed for subscribers of its Aetna health plans. The company’s medical loss ratio fell to 84.6%, compared to 87.3% in the same period a year ago.
CVS attributed the decline primarily to better underlying performance in its government business and the absence of a premium deficiency reserve recorded in the prior year — a liability an insurer must set aside when anticipated claims are expected to exceed the premiums it has collected. Its absence is itself a sign of improved financial positioning.
Total revenue grew more than 6% to $100.4 billion. CVS raised its diluted earnings per share guidance and confirmed it is exiting the individual Affordable Care Act marketplace after this year. Total medical enrollment fell by roughly 600,000 members compared to year-end 2024, and more than one million year-over-year. This marked CVS’s fifth consecutive quarterly earnings beat.
CVS tells the clearest turnaround story in the group. Its stock is up 18% year to date and up nearly 48% from where it traded a year ago, when the company was in the depths of its earnings crisis and had just replaced its CEO. The trajectory is unambiguous — and so is the strategy behind it.
“Margins over membership”
That recovery was not an accident. It was a stated strategy. CVS CEO David Joyner has said repeatedly over the past year that the company is prioritizing “margins over membership” in its Medicare Advantage business. That means exactly what it says: CVS would rather have fewer, more profitable enrollees than a larger membership it cannot price to break even. On the commercial side, Joyner made the same calculus equally plain. “We do see elevated trends. We took a disciplined pricing approach to that in 2025, which has pressured membership, but we’re going to stay disciplined in our pricing approach,” he told investors last August.
“Pressured membership” is the corporate euphemism. What it describes is people being priced out of their plans, and what it means is that Aetna is once again purging customers it considers a drag on profit margins. (It has done that frequently over the past 25 years.)
The membership losses CVS reported this quarter — roughly 600,000 members gone, more than a million year-over-year — are the direct result of that strategy. Wall Street loved it.
Cigna
CI Close (May 11): $289.00 YTD: +5.6% 1-year: −6.5% Dec 31: $273.72 | May 12, 2025: $309.20
Cigna beat analysts on both earnings and revenue in the first quarter, posting $1.65 billion in profit. Its medical loss ratio came in at 79.8%, a favorable shift from the 82.2% posted a year earlier.
Cigna’s unusually low medical loss ratio reflects both aggressive cost management and a significant structural change. The MLR decline is partly attributable to the removal of its Medicare Advantage business, following Cigna’s sale of that book of business to Health Care Service Corporation. Medicare Advantage has been the primary driver of elevated medical costs across the industry. Cigna’s complete exit from MA made the numbers look cleaner.
Cigna also announced it will exit the individual ACA exchange market beginning in 2027. The company raised its full-year 2026 adjusted earnings guidance to at least $30.35 per share.
Evernorth, Cigna’s pharmacy benefit management and health services arm, generated $58.4 billion in revenue for the quarter, far more than the company’s health plan division. Like its peers, Cigna is increasingly a pharmacy and services company that also sells health insurance — not the other way around. (CVS now takes in more revenue from its PBM, Caremark, than from Aetna’s health plans and the company’s 9,000 retail stores.) Cigna’s stock has recovered to a 5.6% year-to-date gain but remains down about 6.5% from a year ago. A strong quarter has not answered the underlying question investors are asking: now that Cigna has exited Medicare Advantage and is exiting the ACA market, where does future growth come from?
Elevance
ELV Close (May 11): $381.84 YTD: +9.6% 1-year: −6.4% Dec 31: $348.40 | May 12, 2025: $407.98
Elevance Health (previously known as Anthem) reported $1.8 billion in first-quarter profit, down about 19% from the same period a year earlier, though the results exceeded Wall Street expectations. The company, which operates Blue Cross plans in 14 states, posted a medical loss ratio of 86.8% — slightly higher than a year ago, reflecting elevated costs in its Medicaid business, but better than analysts had feared.
Adjusted earnings per share came in at $12.58, above analysts’ consensus expectations. Elevance also raised its full-year 2026 adjusted earnings guidance.
One significant complication: Elevance’s results included a $935 million accrual tied to Medicare Advantage risk-adjustment data the company had previously submitted to federal regulators, where the ultimate liability remains uncertain. Risk-adjustment data — the system by which Medicare Advantage plans submit diagnosis codes to justify higher payments — has come under increasing regulatory scrutiny as a driver of what federal analysts estimate are tens of billions of dollars in annual overpayments to private insurers.
CEO Gail Boudreaux told investors that the company saw “moderately stronger retention” in its ACA segment and attributed better-than-expected results partly to a shift by remaining enrollees toward bronze-tier coverage — lower-premium, higher-deductible plans that tend to see lower utilization in the early months of the year. The stock is up nearly 10% year to date but remains about 6% below where it traded a year ago, with the risk-adjustment liability an unresolved overhang.
Humana
HUM Close (May 11): $274.24 YTD: +7.6% 1-year: +10.2% Dec 31: $254.84 | May 12, 2025: $248.93
Humana’s first-quarter results were the most complicated of the group — a beat on paper, but with enough asterisks to keep analysts cautious.
The company’s insurance segment MLR came in at 89.4%, edging out its own target of just under 90%, with medical and pharmacy cost trends running somewhat lower than anticipated. Revenue for the quarter reached $39.6 billion, up sharply from $32.1 billion a year earlier, driven largely by a 25% surge in Medicare Advantage enrollment.
But Humana did not raise its full-year guidance, unlike most of its peers. The company said it expects its second-quarter medical loss ratio to come in slightly above 91%, a deterioration from the first quarter — a signal that the cost pressures driving last year’s sector-wide crisis have not fully abated – and the expectation that Humana picked up many of the more costly MA enrollees that its competitors dropped.
Humana confirmed it expects to earn at least $9 per share for the full year and projects a full-year medical loss ratio of 92.75%, far higher than its rivals. Humana executives said the company’s primary objective is returning to a sustainable individual Medicare Advantage margin of at least 3% by 2028. Getting there will require continued benefit cuts, premium increases, and geographic retreats — all of which bear directly on the Medicare beneficiaries enrolled in Humana’s plans. What that means is that Humana likely will purge many of its new MA enrollees in the same way it did in 2025 after it disappointed Wall Street the year before.
Humana’s stock recovered sharply after the Q1 report, closing Monday at $274.24 — up nearly 8% year to date and up about 10% from a year ago. But investors’ enthusiasm should be tempered by one number: Humana’s aggressive Medicare Advantage membership growth this quarter mirrors exactly what CVS did in 2024, just before badly missing its cost targets as expenses came in far higher than expected. If that pattern repeats, the recovery will be short-lived.
Centene
CNC Close (May 11): $56.35 YTD: +36.9% 1-year: −10.4% Dec 31: $41.15 | May 12, 2025: $62.87
Centene kicked off the year with better-than-expected revenue and adjusted earnings, signaling a recovery from a rough 2025. Its stock rose more than 13% the day after its earnings call — and at nearly 37% year to date, it is the strongest year-to-date performer in the sector so far in 2026.
The company posted total revenues of $49.9 billion, with its consolidated medical loss ratio falling slightly to 87.3%. Adjusted diluted earnings per share came in at $3.37, and Centene raised its full-year adjusted EPS guidance to above $3.40.
Centene is primarily a Medicaid and ACA marketplace insurer, and its recovery story is rooted in those markets. The company’s Medicaid medical loss ratio fell half a percentage point — driven by rate increases from states and continued cost management.
The ACA marketplace, however, remains a source of volatility. Centene’s ACA enrollment fell sharply as the expiration of enhanced premium tax credits pushed many lower-income consumers out of the market — a policy shift that, for Centene, paradoxically helped near-term financial results by reducing exposure to a segment that had been generating losses.
As with the rest of the sector, context matters. Centene ended 2025 at $41.15, deeply depressed from its year-ago price of $62.87. The stock has bounced hard off that bottom but remains down more than 10% from where it stood a year ago. The recovery is real but the hole it is recovering from is also real.
Molina
MOH Close (May 11): $185.17 YTD: +6.7% 1-year: −43.5% Dec 31: $173.54 | May 12, 2025: $327.69
Molina is the outlier in the sector’s recovery narrative — the one company whose headline numbers looked genuinely bad, even as management insisted the underlying story was better than it appeared.
Molina reported a 95% year-over-year drop in net income for the first quarter, falling to just $14 million from $298 million in the same period last year. The collapse was driven primarily by a one-time charge: a $93 million impairment of intangible assets tied to the company’s planned 2027 exit from the Medicare Advantage–Part D market.
Total revenue was $10.8 billion, with premium revenue down about 4% year over year. The consolidated medical loss ratio rose to 91.1%, up from 89.2% in the first quarter of 2025.
The company’s executives reaffirmed full-year guidance for about $42 billion in premium revenue and at least $5 in adjusted earnings per share, and CEO Joe Zubretsky called the quarter “solid under the circumstances.” Molina has described 2026 as a “trough year” for its Medicaid margins, with the expectation that new contracts and the exit from unprofitable Medicare lines will improve results in 2027.
The stock market has rendered a harsher verdict. Molina’s shares are down 43% from where they traded a year ago — by far the worst one-year performance in the sector. The 7% year-to-date gain is recovery from a floor, not a foundation. Investors who held the stock through 2025 have lost nearly half their money.
The Second Quarter Will Be the Real Test
From Wall Street’s perspective, the industry has stabilized. Whether the companies’ management teams have learned anything different is a question the second quarter will begin to answer.
Analysts have flagged Q2 as especially critical — particularly for Humana, whose aggressive Medicare Advantage membership growth while holding benefits stable mirrors a pattern CVS followed in 2024, before badly missing its medical loss ratio targets. If that pattern repeats, the stock gains of recent months will not hold.
More broadly, the mechanisms driving this quarter’s “recovery” — premium hikes, benefit cuts, member shedding, and structural exits from unprofitable markets — are not cost reductions. They are cost shifts. The medical spending did not go away. It was simply transferred: onto patients through higher out-of-pocket costs, onto states through Medicaid pressure, and onto the federal government through the ongoing overpayment dynamics in Medicare Advantage that regulators have not yet fully addressed.
Wall Street calls this a recovery but it is worth being precise about what has actually been recovered and what has simply been moved off the balance sheet and onto someone else’s.
Since the pandemic, Americans have ranked the cost of living (often labeled “affordability”) as the top problem they want America’s leaders to address. The typical household budget has many different components, of course. Some of them, such as health care, have been pressuring families for several decades. Problems in other areas, such as housing, have become acute only in recent years. But the rapid rise in overall prices since the beginning of the pandemic has merged these areas into a broader public concern. Although average hourly wages have risen by 30.8% since then1, costs for many core elements of household budgets have risen even more, and most Americans feel that they are at best running in place.2Because the rate of priceincreases remains well above the Federal Reserve Board’s target of 2%, this concern shows no sign of abating, and the effects of the war with Iran will make matters worse.
Health care
Between 1999 and 2024, health care rose from 13% to 18% as a share of GDP, an increase that has serious consequences for family budgets. While wages rose by 119% during this period, workers’ contributions to family health care insurance premiums surged by 308%, almost three times the pace of wages. This increase was not the result of employers shifting the burden of health insurance to workers; the overall cost of insurance premiums rose even faster, by 342%—more than five times as much as the economy-wide rate of inflation. Since the pandemic began, the burden on average families has accelerated: Out-of-pocket expenses per person rose by nearly one-third, from $1,239 to $1,652, in just five years.
Against this backdrop, it is not surprising that health care has risen to the top of Americans’ concerns about affordability. A recent survey found that 32% of respondents were “very worried” about health care costs, compared to 24% for food and groceries, 23% for rent or mortgage payments, 22% for utilities, and 17% for gas and other transportation.
Because the problems of health care in the U.S. are structural and deeply rooted, the prospects for quick relief are not bright.
Housing
Unlike health care, the housing affordability crisis mostly began with the pandemic. Since early 2020, the cost of median-priced housing has risen by 28%, from $317,000 to $405,000, while mortgage interest rates surged from 3.45% to 6.11%.
These increases have disrupted the long-established balance between housing prices and household incomes. Until 2020, a median-income household could afford mortgages to buy median-priced homes. Now, households need incomes of $120,000 to qualify for such mortgages, but the median income stands at only $85,000. Otherwise put, families in the middle of the income distribution can afford houses that cost about $330,000, 20% below the sales price of the median home. The result: the majority of homes are now beyond the reach of average families.
This development has hurt young families trying to buy their first homes especially hard. For decades, the median age for first home purchases moved in a narrow range between 29 and 31 years—about when young adults were getting married and starting families. Today, the median age for first home purchases stands at 40 years. Families headed by young adults in their 30s are stuck in apartments that are too small, many in locations that no longer meet their changing needs.
Mounting evidence suggests that the receding prospect for homeownership has troubling ripple effects. Because home ownership is the most reliable source of wealth accumulation for average families, lower rates of homeownership will diminish the assets on which many families can draw as they move through the life cycle. Young adults who have given up on homeownership have no incentive to save for a down payment, reducing their savings rate and encouraging an outlook focused on the present, not the future. Some are plunging into sports betting, while others are turning to risky investments that are hard to distinguish from gambling. When traditional paths to economic mobility seem blocked, the calculus that leads working-class Americans to buy lottery tickets spreads to educated young people. Homeownership has positive externalities that will be hard to replace.
Groceries
For most Americans, trips to the grocery store provide the most regular and vivid indication of what is happening to prices. Since the beginning of the pandemic, the news has been mostly bad. Overall grocery prices have risen by 31% since February 2020, and for some high-profile items—ground beef, for example—the increase has been much steeper.
Even short-term changes are noticeable. The government’s inflation report for February 2026 showed grocery prices rising by 0.4% during the month, an annual pace of roughly 5%. There was bad news for salad-eaters: Lettuce prices rose by 12.2% during the month, and tomatoes, 6.4%. Coffee prices, which rose by 18.4% in 2025, increased by another 1.7% in February.
The surge in energy prices resulting from the war in Iran will probably ratchet grocery prices up another notch. Much of the food U.S. consumers buy is transported long distances from the point of production, and many of the factories that produce fertilizer for U.S. farmers are located in the Persian Gulf.
Other key elements of the affordability issue
Utilities
Household utility costs have risen by 41% in the five years after the beginning of the pandemic. Electricity is up 32%, water 43%, and natural gas 60%, and 17% of households have fallen behind on their monthly electricity bills. These figures help explain the political sensitivity of AI data centers, which consume large amounts of water and put upward pressure on household electricity rates.
Automobiles
Since the onset of the pandemic, the average price of a new car has risen from $38,000 to $50,000, an increase of 32%. Hard-pressed consumers who turned to used cars found little respite; used cars rose by 28% during this period. And auto purchasers have been hit by an array of rising fees, such as “destination charges” for moving purchased autos to the point of sale. Meanwhile, auto insurance premiums have risen by a stunning 55% since the pandemic began.
Child care
Between 2020 and 2024, the average cost of child care rose by 29%, 7 points more than the overall inflation of 22% during these years. Starting in mid-2024, the pace of child care inflation accelerated to twice the rate of overall inflation, a trend that persisted through 2025. Parents are increasingly likely to cite the costs of child-rearing as hard to manage and as a reason to have fewer children than they otherwise would have.
The politics of affordability
The political power of affordability became undeniable when Zohran Mamdani won an improbable victory last November in the contest for mayor of New York, while Mikie Sherrill and Abigail Spanberger won the governorships of New Jersey and Virginia by surprisingly wide margins. Since then, Democratic candidates have continued to press their Republican opponents on the issue, and the inflationary effects of the war in Iran may make the midterms even tougher for the GOP.
The affordability issue has affected President Trump’s standing as well. Most Americans believe that his priorities do not align with theirs, and they want him to focus more on the bread-and-butter challenges they face every day. Whatever the merits of the president’s claim that he inherited these challenges, Americans reject it by a margin of 2-to-1. It is Mr. Trump’s economy now, and Americans want him to do more to fix it than he has so far.
The electorate’s judgment matters because President Trump’s job approval affects his party’s prospects in the forthcoming midterm election. Right now, his dismal approval rating of 34% for his handling of inflation is endangering the survival of Republican House candidates in swing districts and is raising the odds (which are still low) that Democrats will take control of the Senate. With the war in Iran raising energy prices, which will flow through much of the economy, the time for the administration to turn this around is growing shorter.
Last Friday, Chicago Fed President Austan Goolsbee noted that rising unemployment on top of an oil price shock creates “exactly the kind of stagflationary environment that’s as uncomfortable as any that faces a central bank,” per the Wall Street Journal.
Flashback:
Analysts and media started tossing out the “s” word when inflation revved up back in 2021.
The term “stagflation” really took off the next year, when Russia invaded Ukraine, spiking energy prices. Everyone then predicted a recession that never materialized.
State of play:
Today is different for two reasons. First, the job market is more sluggish than it was a few years ago.
Second, the oil shock from the Iran war is potentially magnitudes larger than from the Russian war, taking 20% of global supply oil off the board.
“Disruption to the Strait of Hormuz creates a far larger potential supply shock that extends beyond oil,” Skylar Montgomery Koning, a macro strategist with Bloomberg, wrote in a note.
“Shipping flows more broadly are being disrupted. That is pushing up energy and food costs, lifting inflation and squeezing growth.”
“This stagflationary mix is particularly toxic for markets, as it increases the risk that bonds and equities sell off together.”
Reality check:
It’s not the 1970s. Economists believe the Iran war will slow economic growth and cause an increase in inflation, but not to the extremes seen back then.
“If you want the word ‘stagflation’ with a very little ‘s,’ you could,” says David Kelly, chief global strategist at JPMorgan Asset Management.
He recently revised his economic growth projections slightly downward this year due to the war. And he is projecting slightly higher inflation.
The difference between now and the 1970s is, back then, higher prices led to wage increases, which led to more inflation in a wage-price spiral that got out of hand, he says. Workers just don’t have the power for that today.
“This is probably just going to slow the economy down, rather than trigger some long wave of inflation,” says Michael Madowitz, principal economist at the progressive Roosevelt Institute.
The bottom line:
This is not your father’s economic shock. Yesteryear’s bell bottoms would look a bit weird if you trotted them out today.
