Managed Care Organizations: Industry Landscape and Outlook to 2035
Regulatory Change is Impacting the US Managed Care Industry
New federal policy is tightening eligibility for both individual exchange and Medicaid coverage, putting insurers concentrated in those markets under closer scrutiny through 2027. Regulations tied to the One Big Beautiful Bill Act are expected to reduce the US insured population in coming years.
At the same time, medical cost ratios—currently running about 400 basis points above historical norms—are expected to improve by more than 150 basis points over the next decade. After medical insurance margins hit a trough in 2025, MCO shares have rebounded roughly 35% over the past year.
Regulatory change, margin pressure, and shifting government policy are reshaping how MCOs generate profit—and what comes next matters for anyone tracking the US healthcare sector. Download Morningstar’s 2026 MCO Industry Pulse to learn more.
