Under the "No Surprises Act," insurers are losing over 80% of arbitration cases to providers regarding out-of-network bills. This creates a structural headwind for margins as insurers are forced to pay higher rates than anticipated. Additionally, the State of the Union address is expected to target insurer profitability and affordability, adding headline risk. WATCH / AVOID. Regulatory relief or changes to the arbitration process could alleviate cost pressures.