UnitedHealth Group, the giant conglomerate, is still struggling to show signs of recovery from last year’s steep decline in profits, even as the company reported first-quarter earnings on Tuesday that were higher than Wall Street expectations.
The company’s earnings were relatively flat year over year, reflecting UnitedHealth Group’s difficulties in navigating rising medical costs, government scrutiny of its billing practices and the sustained general public distrust of health insurers. It is the first of the major for-profit insurers to report results for the first quarter of 2026, signaling the potential for a continuation of industrywide challenges.
The company reported earnings from operations for the first three months of 2026 of $9 billion on revenue of $112 billion, on par with its 2025 first-quarter results. Its overall revenue for last year totaled $448 billion.
United modestly raised its profit outlook for 2026 to greater than $17.35 a share.
Once one of the nation’s most highly valued and respected companies, UnitedHealth posted sharply lower results last spring that led the company’s stock price to plummet. The stock lost nearly half its value in a matter of months.
The company abruptly replaced its chief executive, bringing back Stephen Hemsley, a former C.E.O. who vowed to go through all of the company’s businesses and return it to double-digit growth.
UnitedHealth had long prospered from its ability to amass an unparalleled range of health care businesses, from the nation’s largest health insurer to giant data operations to doctors’ practices to pharmacy benefit services.
The company owns UnitedHealthcare, the insurer that pays for the care of 49 million people, and is one of the largest sellers of plans for Medicare Advantage, the private plans under Medicare that now cover health care for about half of the beneficiaries who are 65 or older or have disabilities. It operates Optum, which delivers care through a vast network of about 90,000 affiliated doctors. Its giant pharmacy benefit manager, Optum Rx, handles about 60 million patients’ prescriptions.
The conglomerate also owns Change Healthcare, the clearinghouse that processes more than a third of all U.S. claims among pharmacies, doctors, hospitals and the insurers and was the target of a devastating cyberattack.
That vulnerability and United’s outsize influence on so many health sectors led some lawmakers to call for the company to be broken up.
Since last spring, United’s sprawling expansion has largely ended, with the company now describing how it is reducing costs — exiting businesses, including some in Britain and elsewhere outside the United States; overhauling its executive ranks; and dropping plans in unprofitable markets.
In announcing the company’s results for the first three months of 2026, UnitedHealth executives pointed to those efforts. “We are continuing to help simplify and modernize health care for the people we serve, bringing greater value, affordability, transparency and connectivity,” Mr. Hemsley said in a statement.
One of the biggest setbacks has been the decline in what had been an extremely lucrative Medicare Advantage business. Federal officials have cracked down on the plans’ ability to overcharge the government for their services by exaggerating the prevalence of some diagnoses. Some of those practices are still under federal scrutiny.
That market has also become less profitable for UnitedHealth as the insured become sicker and medical costs rise overall. The company said it had shed nearly one million customers in the Medicare Advantage market.
And it announced an estimated $6 billion drop in this year’s revenue, based on the U.S. government’s decision to change how it pays for Medicare Advantage services, including those provided by UnitedHealth and Optum.
Along with the nation’s other major insurers, United has become the target of an outpouring of rage and frustration among the public and lawmakers, who cite the industry’s practice of prior authorization for some services leading to delays and denial of necessary care.
In late 2024, its top health insurance executive Brian Thompson, was gunned down in midtown Manhattan, a killing that unleashed a visceral public animus toward insurers.
Reed Abelson covers the business of health care, focusing on how financial incentives are affecting the delivery of care, from the costs to consumers to the profits to providers.
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