UnitedHealth Earnings Drag Dow While S&P Hits Record

UnitedHealth Group’s earnings report on Jan. 27, 2026, and its 2026 outlook triggered a broad selloff that weighed on the Dow, even as technology and AI gains pushed the S&P 500 to a record close at 6,978.58.

Results and Outlook

UnitedHealth’s fourth-quarter revenue rose 12.3% year-over-year to $113.2 billion, but net earnings plunged to $218 million from $2.8 billion a year earlier. Adjusted earnings per share were $2.11. The quarter included $1.6 billion in charges, including $799 million related to a Change Healthcare cyberattack and $2.5 billion for restructuring, partially offset by a $442 million divestiture gain. UnitedHealthcare’s segment revenue grew about 17% to $87.1 billion, while Optum’s revenue rose about 8% to $70.3 billion.

The company said in a press release on Jan. 27, 2026, that full-year 2025 revenue reached $447.6 billion, up 12% from 2024. Cash flows from operations totaled $19.7 billion, about 1.5 times net income. The adjusted medical-care ratio, which measures the share of premiums spent on medical care, rose to 88.9% from 85.5% the prior year. UnitedHealthcare served about 49.8 million members in 2025, generating $344.9 billion in revenue, while Optum recorded $270.6 billion.

For 2026, UnitedHealth projected revenue above $439.0 billion, a roughly 2% decline, with earnings from operations exceeding $24.0 billion and adjusted EPS above $17.75. The consolidated medical-care ratio is expected near 88.8%, plus or minus 50 basis points. UnitedHealthcare membership is forecast between 46.9 million and 47.5 million, reflecting a swing of more than 1.1 million members due to market exits. Optum’s 2026 revenue target is above $257.5 billion with an operating margin around 5.1%. Chief Executive Stephen Hemsley said, "We confronted challenges directly and finished 2025 as a stronger company, giving us the momentum to better serve those who count on us and continue to improve our core performance." [source:4]

Market Impact and Medicare Risks

The outlook sparked a steep selloff that erased about $99 billion of UnitedHealth’s market value. On Jan. 27, the Dow fell 0.83% to 49,003.42, while the S&P 500 rose 0.41% to a record 6,978.58 and the Nasdaq gained 0.91%, boosted by strength in technology and AI sectors. UnitedHealth’s stock dropped roughly 12% to 20% in early trading as investors reacted to the weaker revenue forecast and a small Medicare Advantage rate increase of 0.09% for 2027, down from 5.06% the prior year.

The company has flagged that funding reductions from the Centers for Medicare & Medicaid Services (CMS) and changes to a coding framework could reduce revenue by about $6 billion. UnitedHealth also faces ongoing civil and criminal inquiries related to its Medicare business.