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Tuesday, Jul 8 2025

Full Issue

Centene Withdraws Earnings Forecast, Triggering Possible Credit Downgrade

S&P Global Ratings is considering whether to reclassify Centene Corp.'s credit ratings to junk, which would strongly impact its borrowing power. Centene, the top seller of ACA health plans, is suffering from financial uncertainty due to federal crackdowns on Affordable Care Act enrollments.

S&P Global Ratings said it鈥檚 considering cutting Centene Corp.鈥檚 credit ratings to junk, citing the health insurer鈥檚 suspending its 2025 profit outlook. Centene said last week that it was withdrawing its previous forecast for its earnings for the year, because insurance market trends were veering from its assumptions, particularly in the plans it offers under the Affordable Care Act. Without that information, S&P has less confidence that the insurer will build the capital it needs quickly enough, the bond grader said in a statement on Monday. (Hall, 7/7)

Molina Healthcare became the latest health insurer to warn that higher medical costs will hit earnings this year, adding to Wall Street鈥檚 worries about an industry already facing the loss of millions of customers because of the newly passed Republican megabill. Last week, shares plunged across the industry after Molina鈥檚 larger competitor Centene withdrew its financial guidance for 2025, saying its profits would fall well short of what the company previously expected. In the wake of that, Molina鈥檚 announcement wasn鈥檛 a complete surprise, limiting the immediate downside to the shares of the California-based managed care company and its competitors. (Wilde Mathews, 7/7)

Health insurance companies will trade $10.4 billion in exchange risk-adjustment payments this year, the Centers for Medicare and Medicaid Services announced. Centene, CVS Health subsidiary Aetna and UnitedHealth Group subsidiary UnitedHealthcare are set to receive more than expected, while Cigna, Elevance Health, Molina Healthcare and Oscar Health will owe greater sums than projected, according to an analysis of CMS data and corporate financial disclosures by the investment bank Barclays Capital. (Tepper, 7/7)

A health-care system serving the largest retirement community in the US has filed for bankruptcy after disclosing it potentially overbilled Medicare by at least $350 million, according to court filings. The Villages Health System LLC, which operates clinics for retirees living in the Villages in Central Florida, said in a July 3 court filing that it logged patient diagnoses that 鈥渨ere not clinically supported or otherwise did not meet Medicare coding and payment guidance.鈥 (Randles, 7/7)

More health industry news 鈥

Some hospitals in the U.S. are without essential staff because international doctors who were set to start their medical training this week were delayed by the Trump administration鈥檚 travel and visa restrictions. It鈥檚 unclear exactly how many foreign medical residents were unable to start their assignments, but six medical residents interviewed by The Associated Press say they鈥檝e undergone years of training and work only to be stopped at the finish line by what is usually a procedural step. (Ramakrishnan and Shastri, 7/4)

Northwestern Medicine has launched a program to help patients who have concerns related to obesity and are planning a pregnancy. Women with higher levels of body fat sometimes struggle to conceive and can face greater health risks during pregnancy. The PEARL program, which stands for Preconception and Early Assessment Care Rooted in Lifestyle Management, aims to help these patients have safe and healthy pregnancies. (Weaver, 7/5)

In pharmaceutical developments 鈥

Novartis AG won regulatory approval for the first medicine designed for babies with malaria, the latest development in the global fight against the mosquito-borne disease. The Swiss drugmaker said Tuesday the country鈥檚 agency Swissmedic approved a new formulation of its drug Coartem to treat infants weighing from 2 kilograms to under 5 kilograms (11 pounds). The company expects approval from eight countries in Africa to follow, and plans to roll out the treatment on a 鈥渓argely not-for-profit basis,鈥 it said. (Petroff, 7/8)

KalVista Pharmaceuticals Inc. shares jumped after the company said it received US Food and Drug Administration approval for its pill for hereditary angioedema, a rare and potentially deadly condition that causes severe swelling throughout the body. KalVista said last month that regulators had delayed making a decision on its drug due to the agency鈥檚 鈥渉eavy workload and limited resources鈥 after the FDA told the company it would miss a June deadline for approval. (Koons, 7/7)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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