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Health insurers are scaling back their Medicare Advantage offerings in less profitable markets, but some are finding new opportunities covering some of the sickest Americans.

The big picture: Private Medicare is becoming less about geographic saturation than finding a profitable niche caring for seniors with chronic conditions like diabetes, heart failure or kidney disease.

• Because the government pays MA insurers more to take on sicker enrollees, specialized "chronic condition special needs plans," or C-SNPs, tend to have higher profit margins.

State of play: Open enrollment for 2026 Medicare coverage — including the MA plans that now cover more than half of seniors — began last week.

• The number of plans offered declined in 35 states, and the overall number of standard plans is down 9% from last year, with major players like Aetna and UnitedHealthcare shrinking their footprints.
• CMS projects that enrollment could fall by about 900,000 next year as more insurers withdraw from regions.

The companies partly blame changes the Biden administration made to the way they get paid, as well as rising costs driven by higher demand for medical services.

• "The combination of funding cuts, rising health care costs and increased utilization have created headwinds that no organization can ignore," Bobby Hunter, who runs government programs for UnitedHealth's parent, said on an earnings call this month.

Yes, but: Plans targeting enrollees with chronic illnesses will increase 42% this coming year, according ATI Advisory.

How it works: The plans cover the same benefits as regular MA insurance, including drugs, but also pay for services like extra days in the hospital for someone with cancer or congestive heart failure. Many have no monthly premium.

• It's part of a broader trend in which the greatest-needs population is driving insurers' revenue growth. Health plans also are catering to low-income people with complex health needs who are eligible for both Medicare and Medicaid.

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The maker of Tylenol is pushing back against efforts to change the pregnancy warning on acetaminophen products, saying there's no evidence showing a proven link between autism and the use of the pain reliever and fever reducer.

Why it matters: It's the latest development stemming from President Trump and Health Secretary Robert F. Kennedy Jr. stating there may be a link between Tylenol use among pregnant women and autism in children.

• Kennedy on Sept. 22 announced a series of actions, including directing the FDA to begin a safety label change for Tylenol and generic equivalents.
• The FDA separately issued a notice to physicians urging them to minimize the use of acetaminophen during pregnancy for routine low-grade fevers.

What they're saying: Kenvue Brands said yesterday that it told the FDA the labeling request is unsupported by scientific evidence and would mark a departure from the agency's long-standing position on acetaminophen during pregnancy.

• The FDA evaluated the evidence for more than a decade — and as recently as August — repeatedly concluding that the data doesn't support a causal association, Kenvue said. The FDA also previously rejected updating the pregnancy warning.
• "Kenvue strongly believes that the existing instruction 'if pregnant or breast-feeding, ask a health professional before use' is the most conservative and appropriate warning," the company said.

GLP-1 drug stocks finished last week in a slump after Trump signaled plans to drive down the price of at least one of the blockbuster weight-loss and diabetes treatments.

Why it matters: GLP-1 drugs remain too expensive for many Americans as Medicare and many private insurance plans don't cover them for weight loss.

Catch up quick: Trump said that the price of Novo Nordisk's Ozempic will soon be "much lower."

• "Those are going to be $150 out of pocket," he told reporters on Thursday, referring to the monthly cost of a drug whose list price is about $1,000, per Reuters.

The impact: Shares of Novo and Eli Lilly, which makes Zepbound and Wegovy, fell 3.1% and 2%, respectively Friday.

• Shares of Viking Therapeutics, which is developing GLP-1 drugs, fell 3.4%.

The big picture: The Trump administration wants pharmaceutical companies to commit to bring U.S. prices in line with the lowest paid by other developed nations.

• Pfizer recently agreed to offer almost all of its drugs to Medicaid at "most-favored nation" prices and said it wouldn't charge more in the U.S. for new drugs it launches than in other wealthy countries.

Every day, healthcare distributors power the pharmaceutical supply chain that keeps America healthy.

Their impact: 10.5 million medicines delivered, 600,000 sites of care reached and 1,400 manufacturers connected.

Connecting care across communities.

An expanded Medicare coverage policy is prompting more older adults to get cochlear implants when a hearing aid isn't enough, the New York Times reports.

Why it matters: The devices, surgery and follow-up can cost $100,000 or more for people without insurance.

• While research has shown hearing aids can slow cognitive decline, many people who know they have hearing loss avoid them.

Driving the news: The American Cochlear Implant Alliance estimates the number of implants is increasing by about 10% annually, though public awareness and referrals from audiologists remain low, the Times reports.

• Implantation was increasing the most in patients over 80, a 2023 study found.

Medicare until recently covered the procedure for only those who could correctly repeat less than 40% of the words on a word recognition test. Three years ago, it expanded coverage to those who could identify up to 60%, increasing the pool of eligible patients.

• Still, the Times notes, implantation requires commitment. The outpatient procedure takes several hours and involves implanting a receiver beneath the scalp and inserting electrodes to stimulate the auditory nerve.