DD: Trump / CMS will TACO on Medicare Advantage Reimbursement Rates, Buy the Dip on Health Ins

Today CMS (Center for Medicare and Medicaid Services) proposed MA (Medicare Advantage) reimbursement rate increase of 0.09% for 2027, well below the expected 6%. This lead to $92B market cap wipeout today across health insurance stocks including UNH -20% CVS -15% CNC -11% HUM -20%.

This is a complete no go because MA margins are already squeezed and MA plans have been a growth driver for the industry. According to [PWC](https://www.pwc.com/us/en/industries/health-services/medicare-advantage-margin-compression.html), in 2024 MA plans had an underwriting margin of -1% on average (meaning providers were losing money) and over 70% of the enrollees are breakeven or in loss. I contacted a health actuary friend who said that they expect Trump to back down after pressure from the industry. They also don't think the reported negative margin is accurate because MA plans have been a big revenue driver in the industry.

CMS will publish the final rate on April 6. That leaves plenty of time for the industry to lobby for a more appropriate rate increase. This is very similar to Trump's 10% CC cap proposal, where he is just spewing some anti industry populist message without thinking about the math and numbers. The total rebate in 2024 was about $78B (I have trouble finding the exact figure), so the missing 5.91% increase comes out to the ballpark of $4.6B on the line for the industry. And because this is an increase rate, any reduced rate this year will compound indefinitely into the future.

TDLR TACO buy the dip

[Positions: IHF 25 x $45.62 IHF 5/15/2026 49.0 C 20 x $1.16](https://imgur.com/a/hqyqgry)

Not a large position because I find healthcare plays boring.