There has been one word health insurers have not been shying away from in 2026: discipline.
Elevated utilization for specialty drugs, behavioral health and emergency services has been driving medical costs in recent years. As insurers face pressures across lines of business, they are forced to consider whether cautious restraint, rather than pushes for further expansion, is their most compelling strategy.
Here is where the discipline theme emerged during earnings calls throughout 2026.
Capital
For Humana, the term surfaced as leaders discussed available capital and possible divestitures for the year.
“We are pursuing noncore asset divestitures to help fund strategic acquisitions and expect to share more news with you on this front over the next several months. All-in, we are pleased with the results of our balance sheet enhancements and are comfortable with our capital levels, which provide a prudent buffer above regulatory and rating agency requirements,” Humana CFO Celeste Mellet said in a first-quarter earnings call. “Consistent with this disciplined approach, we continue to evaluate a pipeline of initiatives to further strengthen the balance sheet.”
Humana agreed to sell its remaining stake in hospice operator Gentiva for $900 million, according to a June 10 announcement. Proceeds from the sale will go toward general corporate uses.
The Cigna Group’s CFO, Ann Dennison, said the company repurchased about 900,000 shares of common stock for roughly $250 million in the second quarter of 2026. There were no share repurchases in the first quarter. However, in 2025, Cigna repurchased 11.9 million shares of common stock for around $3.6 billion.
“We continue to view share repurchases as an attractive use of capital while maintaining a focus on debt paydown and disciplined capital management,” she said on the company’s earnings call.
Medicare Advantage
In 2027, Humana plans to walk back Medicare Advantage coverage for roughly 600,000 members, following a wave of exits in 2025. The company said it is focusing on margin recovery and aims to recapture member volume. Humana stood out among other national insurers during the previous annual enrollment period, touting outsized MA membership.
“We are pleased with the solid start to 2026 and believe our expanded membership base, relentless focus on returning to top-quartile Stars and pricing discipline position us well to deliver stable and compelling MA margin and unlock the earnings potential of the business by 2028,” Ms. Mellet said.
UnitedHealthcare and Elevance Health have also embraced disciplined approaches with Medicare.
“Medicare and retirement results reflect disciplined pricing strengthened by affordability initiatives, in an elevated but stable medical trend environment,” UnitedHealthcare CEO Tim Noel said during a first-quarter earnings call.
Elevance CEO Gail Boudreaux said the company is aiming for at least a 2% operating margin in MA in 2026.
“Disciplined plan design, a more focused mix of D-SNP and HMO products, favorable claims experience, and the growing impact of our care management programs support our path to at least a 2% operating margin this year,” Ms. Boudreaux said. “Our 2027 bids were developed with the same discipline, reflecting a prudent view of cost trend, continued focus on margin improvement and stability in the benefits that members value most.”
Medicaid
Elevance expects a -1.75% operating margin for its Medicaid business, according to CFO Mark Kaye.
“The Medicaid environment continues to be dynamic, and we’re managing it with discipline,” Ms. Boudreaux said.
The company exited the Medicaid managed care program in Washington, D.C., in 2026, and suggested further pullback. A Louisiana managed Medicaid contract from Elevance’s joint venture with Blue Cross and Blue Shield of Louisiana will end Dec. 31, as well.
Centene CEO Sarah London said the company ended the second quarter of 2026 with a larger drop in membership than expected, resulting in just over 12 million members. She partially attributed this to state program changes.
She still said that “Medicaid results were in line with our expectations for the quarter, driven by disciplined execution against our operational and financial goals.”
Molina Healthcare President and CEO Joseph Zubretsky said the company expects 2026 to be a “trough year for Medicaid pre-tax margins” as future rate increases could align more closely with medical cost trend, something that Ms. Boudreaux echoed.
“We remain confident in our disciplined approach to medical cost management and believe the premium and earnings per share building blocks position us well for profitable growth in 2027,” he said.
Commercial
Cigna shifted its focus to commercial coverage following the 2025 sale of its MA business to Health Care Service Corp. Looking specifically at the Cigna Healthcare insurance business, Ms. Dennison pointed to performance driven by “disciplined pricing, effective care coordination and focused execution.”
Despite an elevated cost trend, Elevance is trying to be conscientious with pricing for 2027.
“Commercial group performance was in line with our expectations, with cost trend remaining elevated but consistent with the pricing approach we have taken,” Mr. Kaye said. “We have applied the same discipline to the 2027 selling season.”
Some insurers have asked for steep rate increases for 2027. Leading up to ACA rates being finalized, insurers sought a 15% median rate increase for 2027, according to a Peterson-KFF Health System Tracker analysis.
Across all lines of business, insurers are reassuring investors that they will overcome headwinds through controlled management of resources, rather than a growth-at-all-costs approach.
