By Mackenzie Tatananni and George Glover

UnitedHealth Group reported weaker-than-expected quarterly revenue on Tuesday, sending shares even lower after they took a blow from the Trump administration's plan to keep Medicare Advantage rates roughly flat.

The stock tumbled 12% to $309.80 ahead of the opening bell. Futures tracking the S&P 500 rose 0.3%.

Shares were already about 8% down before UnitedHealth's earnings report. The Centers for Medicare and Medicaid Services proposed late Monday for payments to private Medicare Advantage plans to rise by 0.09% on average in 2027, well below what analysts had been expecting.

Things went from bad to worse following the results. UnitedHealth reported an adjusted profit of $2.11 a share, as revenue climbed 12% from a year ago to $113.2 billion. Analysts were expecting adjusted earnings of $2.10 a share from revenue of $113.8 billion, according to FactSet.

The company's revenue guidance for 2026 also looked weak. UnitedHealth is forecasting adjusted earnings of more than $17.75 a share on revenue of more than $439 billion. Wall Street was looking for earnings of $17.74 a share and revenue of $454 billion.

This is breaking news. Read a preview of UnitedHealth below and check back for more analysis soon.

UnitedHealth Group's earnings, due for release Tuesday morning, could prolong, or end, a comeback in the stock since the start of the year.

The company, which operates through its UnitedHealthcare arm and Optum health services division, gave the market plenty to worry about last year. In April, UnitedHealth slashed its financial guidance, citing higher-than-expected utilization rates in its Medicare Advantage health-insurance business.

A month later, the company withdrew its outlook altogether and announced that Andrew Witty, the CEO at the time, had resigned. Shares plunged more than 50% between April 15 and May 15 and have struggled to claw their way back.

The stock got a temporary bump at the time of UnitedHealth's last earnings report in October, but those gains quickly faded. Still, they have been helped here and there by some positive commentary on Wall Street and developments such as Berkshire Hathaway's disclosure of a stake in the company.

So far this year, shares have gained 6.5%, which means they are faring better than other players in the healthcare sector such as CVS Health, up 5.7%, and Cigna Group, up 1.9%. The stock is also outperforming the S&P 500, which is up 1.5% year to date.

All eyes will be on the company's full-year financial guidance. Management previously said it was targeting "double-digit growth beginning in 2027 and advancing from there." Wall Street is expecting adjusted earnings of $2.10 a share from revenue of $113.8 billion, compared with $2.92 and $113.2 billion in revenue for its third quarter.

The stock's recent resilience may be due in part to UnitedHealth's seemingly unshakable market dominance. With a market capitalization of around $322.7 billion, it is by far the largest healthcare player in the U.S.

Still, concerns remain. Deutsche Bank analysts posited in October that hopes for a long-term recovery may already be priced into the shares, limiting how far they can rise in the near term. Then there is growing hostility at the federal level.

President Donald Trump has called on insurers to lower their prices, referring to them as "big, fat, (and) rich" on social media and even vowing to "call a meeting of the insurance companies" last month. It isn't clear how effective that would be, seeing as the cost of medical care -- the rates charged by hospitals and doctors -- is a critical factor in determining prices for insurance.

Just last week, representatives from UnitedHealth and CVS Health faced off with members of Congress as they fielded questions about rising costs in the healthcare system.

CEO Stephen Hemsley said in written testimony ahead of the hearing that UnitedHealth would return any profits made in the Affordable Care Act marketplace to consumers in the coming year. The company plans to "voluntarily eliminate and rebate our profits this year for these coverages," he wrote.

Write to Mackenzie Tatananni at mackenzie.tatananni@barrons.com

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January 27, 2026 06:18 ET (11:18 GMT)

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