The annual HealthScape Advisors report shows that 73% of all health insurance companies in 2025 posted an operating loss. In 2023, this number was 54%.
The 2025 HealthScape report indicates that a large majority of these organizations are small-to-medium regional health insurers, with 43% of national insurance companies operating at a loss in 2025. This number was only 14% in 2024.
The number of health insurers reporting 3 consecutive years of operating losses in 2025 is 35%, up from 26% in 2023. This year’s report discusses how the health insurers’ significant improvements in controlling administrative costs aren’t enough to offset the higher increases these organizations are seeing in medical costs.
This year’s report recommends several different “strategic priorities” all health insurers should consider on capital allocation, portfolio decisions, and more strategic alignments with critical provider partners who see their health insurance members.
The HealthScape reports show how the medical cost pressures we see in the ACA, Medicare, and Medicaid markets have also spread to the commercial, small group, and other health insurance sectors in the last few years, and are getting worse.
What Should Health Insurance Agents Do?
Insurance agents should inform themselves about their health insurance operational financial numbers. For example, so far in 2026, several health insurers are seeing much better financial numbers than in 2025.
The better their financial operations numbers are, the more likely it is they have either the same health benefits or better in 2027. So, insurance agents need to know which “bucket” each of their current health insurer partners is in.
Are they in the 2025 operational loss-only bucket, or are they in the 3 consecutive years of operational losses bucket? If they’re in one of these buckets, is the health insurer doing better so far in 2026?
If they’re still struggling so far in 2026, insurance agents should evaluate their partnership with this organization to determine whether it’ll be the best option for your 2027 health insurance clients. All health insurance agents should try to maximize the number of health insurer partners they have operating at a profit for 2025 and 2026.
All health insurance agents, not just ACA and Medicare agents, also need a strong portfolio of ancillary and supplemental products to protect 2027 clients financially from higher medical costs they may see. Knowledge is power, and insurance agents need as much knowledge about their health insurance partners now as possible to empower themselves to best serve and support their health insurance clients in 2027.
The Agility Difference
With the ongoing evolution of the insurance market, Agility empowers you to identify your defining characteristic through our team’s expertise, positioning you for growth. With Agility, you also get Dedicated Producer Support at (866) 590-9771 or support@enrollinsurance.com to answer any insurance questions and direct you to our Medicare, ACA, and ancillary experts.
They can also add you to our weekly email list for tips and updates. Let Agility empower you to evolve your capabilities and capture the opportunities in 2026.
