[GUEST ACCESS MODE: Data is scrambled or limited to provide examples. Make requests using your API key to unlock full data. Check https://lunarcrush.ai/auth for authentication information.]  Say No To Trading [@SayNoToTrading](/creator/twitter/SayNoToTrading) on x 6334 followers Created: 2025-07-22 06:01:00 UTC A lot of people are asking about the emergency rate increases insurers are seeking: Medicaid: Yes, amendments allowed mid-year with CMS approval if costs shift significantly. State deadlines (mid-2025 for 2026) can be bypassed for justified changes. $MOH and $CNC have highest exposure. $UNH and $ELV much lower. ACA Marketplace: Yes, revisions allowed before final approval (Aug-Sep 2025), even past initial deadlines (May-Jul 2025). $OSCR is primarily marketplace. Odds of success? Per Grok 4, 60-90% chance for meaningful hikes. Stronger in ACA (routine approvals) than Medicaid (state budget constraints). The insurers' scale and data on cost pressures (e.g., post-redetermination acuity) boost odds, but large Medicaid hikes need CMS approval and justification. What can they get? Medicaid: Premiums that result in a 0.5-2.5% explicit margin, targeting 2-4% pre-tax profit. ACA: Up to 15-20% for admin/profit (80-85% medical loss ratio), aiming for 3-5% margins. Must justify with cost data. So when you see these stories about emergency rate hikes of 20-25% being sought, they will get approved if the MLR justifies such.  XXXXX engagements  **Related Topics** [cnc](/topic/cnc) [moh](/topic/moh) [marketplace](/topic/marketplace) [aca](/topic/aca) [$moh](/topic/$moh) [molina healthcare inc](/topic/molina-healthcare-inc) [stocks healthcare](/topic/stocks-healthcare) [$cnc](/topic/$cnc) [Post Link](https://x.com/SayNoToTrading/status/1947537341817753744)
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Say No To Trading @SayNoToTrading on x 6334 followers
Created: 2025-07-22 06:01:00 UTC
A lot of people are asking about the emergency rate increases insurers are seeking:
Medicaid: Yes, amendments allowed mid-year with CMS approval if costs shift significantly. State deadlines (mid-2025 for 2026) can be bypassed for justified changes. $MOH and $CNC have highest exposure. $UNH and $ELV much lower.
ACA Marketplace: Yes, revisions allowed before final approval (Aug-Sep 2025), even past initial deadlines (May-Jul 2025). $OSCR is primarily marketplace.
Odds of success?
Per Grok 4, 60-90% chance for meaningful hikes. Stronger in ACA (routine approvals) than Medicaid (state budget constraints). The insurers' scale and data on cost pressures (e.g., post-redetermination acuity) boost odds, but large Medicaid hikes need CMS approval and justification.
What can they get?
Medicaid: Premiums that result in a 0.5-2.5% explicit margin, targeting 2-4% pre-tax profit.
ACA: Up to 15-20% for admin/profit (80-85% medical loss ratio), aiming for 3-5% margins. Must justify with cost data.
So when you see these stories about emergency rate hikes of 20-25% being sought, they will get approved if the MLR justifies such.
XXXXX engagements
Related Topics cnc moh marketplace aca $moh molina healthcare inc stocks healthcare $cnc