Payers reflect on the first half of 2026

The first half of 2026 has been a busy time for health insurers, to say the least.

After years of struggling to contain high medical costs, payers have been performing better than expected this year after taking steps like upping premiums, exiting unprofitable areas and shedding costly Medicare Advantage and Affordable Care Act marketplace enrollees.

But new challenges have arisen. The Affordable Care Act Marketplace’s enhanced premium tax credits expired at the end of 2025, motivating consumers to move to cheaper high-deductible plans or even go uninsured.

At the same time, prior authorization is under reform following consumer backlash against the industry, insurers are investing millions or even billions into AI, and new types of insurance models like individual coverage Health Reimbursement Arrangements (ICHRAs) are growing in popularity.

Amid this flurry of activity, we asked health insurance leaders and industry experts how they feel the first half of the year has gone.

These answers have been lightly edited for length and clarity.

Dan Delaney, managing partner, HealthScape Advisors

The first half of 2026 has started on a cautiously optimistic note. Payer financial performance through Q1 2026 has rebounded, reflecting more accurate pricing against medical trend and the compounding impact of total cost of care initiatives. At the same time, continued exits and product rationalization in Medicare Advantage and ACA markets show that affordability pressures are reshaping the competitive landscape and forcing plans to make increasingly difficult choices about where and how they can sustainably compete.

Anne Docimo, chief medical officer, UnitedHealthcare

The industry, in collaboration with trade association America’s Health Insurance Plans, is making meaningful progress to reduce prior authorization requirements and simplify the experience for patients and providers—helping make care more accessible, easier to navigate, and better coordinated across the health system. UnitedHealthcare is building on that work by eliminating prior authorization requirements by 30% this year, while also advancing efforts to improve access in rural communities and streamline care for pediatric patients.

Amy Flaster, chief medical officer, the Cigna Group

What’s stood out in the first half of 2026 is that we’ve reached a true inflection point. AI is moving quickly from promise to real-world use—helping clinicians intervene earlier and more precisely, with the potential to improve patient outcomes at scale. That momentum also brings responsibility. How we apply these tools—building trust, ensuring safety and clinical oversight, and focusing on where they make a meaningful difference—will determine their impact.

Janet Liang, EVP and president of Oscar Insurance, Oscar Health

One development that stood out in the first half of 2026 was the growing momentum behind ICHRA…For the second half of the year, our focus is on making the individual market easier to navigate—giving employees tools to search for plans, compare costs, and use AI to match coverage to their specific health needs and stage of life, the same way consumers shop in any modern marketplace.