Today is only the start of UNH and HUM's drop

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Author contends UNH and HUM are just beginning a decline because H.R. 7148 ends PBM spread pricing and rebate practices that supported Optum RX, compounded by stagnant Medicare rates.

UNH — SHORT The author argues UNH's decline is beginning because its main growth and profit engine, Optum RX, is threatened by H.R. 7148, which bans PBM spread pricing and requires 100% rebate pass-through, removing middleman pharmacy and brand drug profits. Stagnant Medicare rates compound the pressure and will hurt guidance. The concrete catalyst is the January 2026 House passage and congressional hearings on PBM reform.

UNH's primarily growth and profitability driven had always been Optum RX. They are moving quickly to remove "middleman" pharmacy cuts and name brand drug profits. With the stagnant Medicare rates piling on top, guidance isn't going to look good for these healthcare companies.

HUM — SHORT The author groups HUM with UNH as starting a drop, initially reacting to a Medicare rate increase but driven further by the PBM reform bill. These healthcare companies face worsening guidance from stagnant Medicare rates and removal of PBM middleman profits. The catalyst is the same H.R. 7148 regulatory changes.

I was following some of the threads regarding todays drop of UNH and HUM. It seemed like it was in a reaction to the Medicare rate increase

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I was following some of the threads regarding todays drop of UNH and HUM. It seemed like it was in a reaction to the Medicare rate increase, however with so many insider republicans selling their shares earlier in the week I though something else had to be going on. This 10% drop seems like an over reaction to a Medicare rate increase.

I did some quick research with Gemini and I'm very concerned for UNH. UNH's primarily growth and profitability driven had always been Optum RX. They are moving quickly to remove "middleman" pharmacy cuts and name brand drug profits. With the stagnant Medicare rates piling on top, guidance isn't going to look good for these healthcare companies.

**H.R. 7148**

On January 22, 2026, the U.S. House of Representatives passed the Consolidated Appropriations Act, 2026 (H.R. 7148). This bill contains core elements of the PBM Reform Act.

**Delinking:** It prohibits PBM compensation in Medicare Part D from being tied to the list price of a drug. This effectively ends the incentive for PBMs to prefer higher-priced drugs just to collect a larger percentage.

**100% Rebate Pass-Through:** It requires PBMs to pass 100% of manufacturer rebates directly to plan sponsors (employers) and patients, rather than keeping a "spread" or "kickback."

**Ban on Spread Pricing:** The bill bans "spread pricing" in Medicaid, which is the practice where PBMs charge the government one price and pay the pharmacy a lower price, pocketing the difference.

**The "Showdown" Meetings**

There have been two major high-stakes meetings/hearings in the last 72 hours involving industry leaders:

1. **House Ways and Means Committee (January 26, 2026):** Just hours ago, CEOs from the nation’s largest health insurers and PBMs (including representation from **UnitedHealth/Optum**) testified before Congress. They were grilled on why consolidation has not led to lower premiums and were specifically challenged on "abusing their authority" to prioritize profits over patients.
2. **House Energy and Commerce Committee (January 22, 2026):** This hearing coincided with the House vote and focused on the "PBM Mafia" (a term used by Rep. Buddy Carter during the proceedings). Industry leaders were put on notice that the era of "hidden fees" is being legislated out of existence.

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u/Creative-Sherbet-584 Reddit r/stocks

UNH drop starts on PBM reform hurting Optum RX

The author argues UNH's decline is beginning because its main growth and profit engine, Optum RX, is threatened by H.R. 7148, which bans PBM spread pricing and requires 100% rebate pass-through, removing middleman pharmacy and brand drug profits. Stagnant Medicare rates compound the pressure and will hurt guidance. The concrete catalyst is the January 2026 House passage and congressional hearings on PBM reform.

u/Creative-Sherbet-584 Reddit r/stocks

HUM drop starts on Medicare and PBM pressure

The author groups HUM with UNH as starting a drop, initially reacting to a Medicare rate increase but driven further by the PBM reform bill. These healthcare companies face worsening guidance from stagnant Medicare rates and removal of PBM middleman profits. The catalyst is the same H.R. 7148 regulatory changes.

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