Clover Health Investments, Corp. provides Medicare Advantage plans in the United States. It offers preferred provider organization and health maintenance organization plans to Medicare-eligible individuals. The company also operates Clover Assistant, a software platform for physicians to detect, identify, and manage chronic diseases. Founded in 2014, it is based in Wilmington, Delaware.
Star-rating lawsuit win could restore $120M in bonuses Clover won a lawsuit forcing Medicare to recalculate its star ratings, potentially restoring about $120 million in bonus payments. Higher stars mean more government money and cheaper marketing, directly boosting profit. Rival Elevance is suing over the same decision, so the benefit could shrink or face delays.
This regulatory win is a major new force behind CLOV's outlook and price.
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Q2 profit and raised 2026 guidance Clover reported Q2 revenue of $743 million, up from $478 million, and swung to a $28 million profit from a loss. It raised full-year guidance to as much as $3 billion revenue and $35 million net income. Turning profitable is a big deal for a company investors once doubted.
The profit swing and guidance raise are the clearest new evidence of improving finances.
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Fast membership growth and lower medical costs Clover's Medicare Advantage membership grew strongly while its medical cost ratio fell, meaning it kept more of each premium dollar. Its AI tool, Clover Assistant, is helping control costs. This combination of growth and better underwriting supports the stock because it shows the business can scale profitably.
These operating drivers explain why results beat expectations and support the stock.
Star-rating lawsuit win could restore $120M in bonuses Clover won a lawsuit forcing Medicare to recalculate its star ratings, potentially restoring about $120 million in bonus payments. Higher stars mean more government money and cheaper marketing, directly boosting profit. Rival Elevance is suing over the same decision, so the benefit could shrink or face delays.
This regulatory win is a major new force behind CLOV's outlook and price.
▲
Q2 profit and raised 2026 guidance Clover reported Q2 revenue of $743 million, up from $478 million, and swung to a $28 million profit from a loss. It raised full-year guidance to as much as $3 billion revenue and $35 million net income. Turning profitable is a big deal for a company investors once doubted.
The profit swing and guidance raise are the clearest new evidence of improving finances.
▲
Fast membership growth and lower medical costs Clover's Medicare Advantage membership grew strongly while its medical cost ratio fell, meaning it kept more of each premium dollar. Its AI tool, Clover Assistant, is helping control costs. This combination of growth and better underwriting supports the stock because it shows the business can scale profitably.
These operating drivers explain why results beat expectations and support the stock.
News & notes movingCLOV
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Humana Shrinks Medicare Advantage Footprint for 2027
Humana will offer Medicare Advantage plans in nearly 2,600 counties across 45 states and Washington, D.C. for the 2027 plan year, a sharp reduction from the 46 states and Washington, D.C. it covered for 2026, when its plans reached 85% of U.S. counties. The Louisville, Kentucky-based insurer, the second-largest MA player behind UnitedHealth, said the new footprint represents more than 80% of U.S. counties, and it has announced plans to discontinue offerings affecting 600,000 enrollees. UnitedHealth said its UnitedHealthcare MA plans will remain accessible to 94% of Medicare-eligible individuals next year, unchanged from 2026, though Bloomberg reported that roughly 390,000 people will be part of plans being shut down. CVS Health's Aetna unit and Centene are also pulling back their MA offerings, according to CMS data reviewed by Wall Street analysts, while Alignment Healthcare is expanding to 55 counties and Clover Health said its plans will reach 5.2M Medicare-eligible individuals across 203 counties in five states. The moves come as the MA market contends with rising medical costs and intense government scrutiny, and after CMS said 2027 MA enrollment is expected to reach 34M, a 6% decline, despite a more than 16% drop in MA premiums versus 2026 on a weighted average basis.
HUM · Regulation · Negative Humana is sharply shrinking its 2027 Medicare Advantage footprint and discontinuing plans affecting 600,000 enrollees amid rising costs and government scrutiny.
ALHC · Demand · Positive Alignment Healthcare is expanding its Medicare Advantage footprint to 55 counties, a growth move against peers' pullbacks.
CLOV · Demand · Positive Clover Health said its plans will reach 5.2M Medicare-eligible individuals across 203 counties in five states, an expansion.
CNC · Regulation · Negative Centene is pulling back its Medicare Advantage offerings amid rising medical costs and intense government scrutiny.
CVS · Regulation · Negative CVS Health's Aetna unit is pulling back its Medicare Advantage offerings amid rising medical costs and government scrutiny.
UNH · Regulation · Neutral UnitedHealth's MA plans stay at 94% coverage unchanged, but ~390,000 enrollees are in plans being shut down amid MA market scrutiny and rising costs.
Medicare Advantage Prior Authorization Bill Sinks Insurer Stocks
Bipartisan lawmakers introduced the Protecting Approved Care Act, legislation aimed at reforming prior authorization and payment rules in Medicare Advantage plans, sending several health insurer stocks lower in the morning session. The bill, which received key backing from the American Association of Orthopaedic Surgeons, would require Medicare Advantage health plans to honor initial prior authorizations and strictly prohibit retroactive payment clawbacks. If enacted, the legislation would curtail insurers' ability to adjust or deny reimbursements post-treatment, potentially increasing medical loss ratios and raising administrative compliance burdens across managed care organizations. Among the stocks impacted, Alignment Healthcare fell 12.6%, Clover Health fell 4.8%, Novavax fell 3.6%, and Astrana Health fell 2.7%. Alignment Healthcare's shares are very volatile and have had 23 moves greater than 5% over the last year, and the stock is down 49% since the beginning of the year, trading at $10.32 per share, 58% below its 52-week high of $24.56 from July 2026.
ALHC · Regulation · Negative The Protecting Approved Care Act would bar retroactive clawbacks and force honoring of prior authorizations, raising medical loss ratios for Alignment Healthcare.
ASTH · Regulation · Negative Astrana Health fell as the Medicare Advantage prior-authorization reform bill threatens insurer reimbursement flexibility and raises compliance burdens.
CLOV · Regulation · Negative Clover Health dropped on the bill curtailing Medicare Advantage plans' ability to deny or claw back reimbursements post-treatment.
Brent tops $100, Treasury yields climb as U.S. equities slip
U.S. equities pushed lower on Wednesday as oil kept climbing, with Brent crude breaking above $100 a barrel while U.S.–Iran tensions in the Middle East continued to weigh on sentiment. Treasury yields advanced after the Treasury Department said it will repurchase up to $6 billion of longer-dated notes in Thursday's operation, tripling the size of its last long-end buyback; the 2-year yield rose 2 basis points to 4.42%, the 10-year added 5 basis points to 4.84%, and the 30-year gained about 4 basis points near 5.29%. Brent crude futures surged above $100 per barrel for the first time since July 24, with front-month Brent for November delivery climbing 3.3% to $101.13/bbl and Nymex crude jumping 3.2% to $96.02/bbl, as traffic through the Strait of Hormuz dropped from roughly 8 million barrels per day in late August to only 1 million barrels per day this week, according to Rystad Energy. Separately, Anthropic's Alignment Science Lead Evan Hubinger said he "earnestly" believes AI could kill all humans, putting his personal estimate of the probability at more than 10% within the next decade, and the company's latest risk report upgraded the risk from misalignment in high-stakes settings to "low" from "very low." Managed care stocks declined after CVS Health said at the Wells Fargo Healthcare Conference that it continues to face elevated medical costs, with notable decliners including UnitedHealth, Humana, Clover Health, Alignment Healthcare, Centene, Oscar Health, Elevance Health, and Molina Healthcare.
Health insurance providers reported a strong second quarter, with revenues beating analysts' consensus estimates by 2.8% while next quarter's revenue guidance came in 1.7% below expectations. Clover Health reported revenues of $743.2 million, up 55.6% year on year, exceeding analysts' expectations by 2%, and its stock is up 1.9% since reporting. CVS Health posted revenues of $106.1 billion, up 7.3% year on year, outperforming analysts' expectations by 6.7%, but its stock is down 10.2% since reporting. Progyny delivered the weakest guidance update among its peers, with revenues of $350.5 million, up 5.3% year on year, and its stock is down 15.3% since the results. On average, share prices of the 12 health insurance providers stocks tracked are down 6.2% since the latest earnings results.
Clover Health Posts Profit and Raises 2026 Guidance
Clover Health Investments reported second-quarter 2026 revenue of US$743.17 million, up from US$477.62 million a year earlier, and swung to net income of US$28 million from a net loss of US$10.58 million. The company also raised its full-year 2026 guidance, now projecting total revenues of US$2.92 billion to US$3.00 billion and GAAP net income of US$20 million to US$35 million. Management attributed the improved performance to strong Medicare Advantage membership growth and benefits from its AI-powered Clover Assistant platform. The company's narrative projects US$4.2 billion revenue and US$73.3 million earnings by 2029, implying 18.9% yearly revenue growth.
Clover Health beats Q2 2026 estimates and raises full-year guidance
Clover Health Investments Corp reported second-quarter 2026 revenue and earnings that exceeded expectations, driven by robust Medicare Advantage membership growth and a lower medical cost ratio. The company raised its full-year 2026 guidance, reflecting confidence in sustained profitability, while its Clover Assistant platform gained traction and non-insurance businesses grew rapidly. CEO Andrew Toy and CFO Ryan Schmidt highlighted disciplined cost management, improved underwriting, and a structural shift in the cost base as key drivers of the strong adjusted EBITDA performance. The company received a 3.5-star rating for the 2026 plan year and is investing to reach the 4-star threshold that would unlock bonus payments. Clover Health expects modest near-term membership growth, focusing on profitable expansion and leveraging its technology to manage medical costs, and maintains a strong balance sheet with no debt.
Health insurance stocks rise 37.4% on average after strong Q1 earnings
Health insurance provider stocks tracked by this publication posted a strong first quarter, with revenues beating analyst consensus estimates by 1.4% and next-quarter revenue guidance coming in line. As a group, share prices have risen 37.4% on average since the latest earnings results. Cencora reported revenues of $78.36 billion, up 3.8% year on year but falling short of expectations by 3.9%, leaving its stock flat. CVS Health delivered the biggest beat, with revenues of $100.4 billion up 6.2% year on year and exceeding estimates by 6.3%, driving a 29.2% stock gain. Molina Healthcare's revenues of $10.8 billion, down 3.1% year on year, met expectations but its full-year revenue guidance missed significantly, yet the stock surged 52.6%. Humana's revenues of $39.65 billion, up 23.5% year on year, met estimates and its full-year EPS guidance beat, propelling a 70.4% stock increase. Clover Health achieved the fastest revenue growth at 62% year on year to $749.2 million, beating estimates by 4.8%, and its stock jumped 65.9%.
Counterpart Assistant Use Linked to Stronger Post-Hospitalization Follow-Up, Whitepaper Finds
Counterpart Health released a whitepaper showing that use of its Counterpart Assistant AI platform by primary care physicians is associated with better performance on key care transition measures within Clover Health’s Medicare Advantage population. Members attributed to CA-enabled PCPs had a 33% higher rate of receipt of discharge information and an 11% higher rate of medication reconciliation post-discharge. They also performed 9% higher on the HEDIS Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions measure. The analysis is Counterpart’s eighth retrospective study measuring CA’s clinical impact, building on the data foundation that supported Clover’s number-one HEDIS score nationwide for a PPO Medicare Advantage plan for the last two years.
Clover Health CEO Andrew Toy sold $1.7 million in shares to cover tax obligations
Clover Health Investments CEO Andrew Toy sold 313,476 shares of common stock on July 1, 2026, for approximately $1.67 million. The transaction was a non-discretionary 'sell to cover' event tied to tax withholding obligations from restricted stock unit vesting, not a shift in executive sentiment. Toy's direct holdings declined by 3.16% to 9,609,825 shares, representing a stake valued at about $51.8 million based on the July 1 closing price of $5.39. The sale came shortly after Clover Health shares reached a multi-year high of $5.59 on June 29, and the company recently reported a 51% year-over-year increase in Medicare Advantage memberships in the first quarter of 2026, driving a 62% revenue jump to $749.2 million.
UBS Nearly Doubles Price Target on Clover Health to $4.75
UBS analyst Jonathan Yong nearly doubled the price target on Clover Health Investments to $4.75 from $2.75 while maintaining a Neutral rating, reflecting improving confidence in the company's operating outlook. Earlier, Canaccord raised its target to $4.20 from $3.20 with a Buy rating, citing strong April and May performance and improving managed care conditions. Clover Health, a Medicare Advantage insurer and healthcare technology company, has a projected five-year EPS growth rate of 51.31%.
Elevance Health sues CMS over $115 million in Medicare Advantage bonus payments
Elevance Health has filed a lawsuit against the Centers for Medicare & Medicaid Services, alleging the agency unfairly recalculated Medicare Advantage Star Ratings for competitor Clover Health after finalization, costing Elevance an estimated $115 million in quality bonus payments. The suit claims CMS applied a different standard to Clover Health while denying similar relief to other insurers, creating an uneven competitive landscape. Elevance is asking the court to overturn the decision and restore a consistent ratings process for all Medicare Advantage insurers. The outcome could affect bonus payments and competitive positioning across the industry, with federal spending on Medicare Advantage quality bonuses expected to top $13 billion this year.
Clover Health leads health insurance providers with 62% revenue growth in Q1
Health insurance providers reported strong first-quarter results, with revenues beating analyst consensus estimates by 1.4% on average. Clover Health stood out with revenue of $749.2 million, up 62% year over year and exceeding expectations by 4.8%, while also raising full-year EBITDA guidance. CVS Health posted the biggest beat, with revenue of $100.4 billion, up 6.2% and surpassing estimates by 6.3%. Centene reported $49.94 billion in revenue, up 7.1% and beating by 6.2%, though it lost 1.36 million customers. Molina Healthcare's revenue declined 3.1% to $10.8 billion, missing full-year guidance, and Cencora's revenue of $78.36 billion fell short of estimates by 3.9%. Since reporting, Clover Health's stock has surged 101%, while the group's shares are up 41.9% on average.
Clover Health Director Carladenise Armbrister Edwards Sold 67,160 Shares
Clover Health Investments board member Dr. Carladenise Armbrister Edwards sold 67,160 shares in an open-market transaction on May 18, 2026, according to an SEC filing. The sale, valued at approximately $230,000 based on a weighted average price of $3.42 per share, reduced her direct holdings by 19.05% to 285,432 shares. This marks her second direct sale in two years, following a larger 200,000-share sale in March 2025. The transaction occurred amid a one-year total return of 8.23% for the stock, which has since surged to a 52-week high of $5.49 in late June after a favorable court ruling on Medicare ratings. Edwards has not sold additional shares despite the rally, and her remaining stake suggests continued confidence in the company, which reported a 62% year-over-year revenue increase to $749.2 million in the first quarter and swung to a net profit of $27.3 million.
Clover Health Named Top Russell 2000 Pick, Rush Street and Nelnet Flagged as Risky
StockStory identified Clover Health as a Russell 2000 stock to own for decades, citing exceptional 31.2% annual revenue growth over the last two years, rising adjusted operating profits, and positive free cash flow. The firm flagged Rush Street Interactive and Nelnet as risky, pointing to Rush Street's below-peer operating margin of 6.9% and Nelnet's muted 5.5% annual revenue growth and 8.4% return on equity. Clover Health trades at 57.9 times forward earnings, Rush Street at 44.2 times, and Nelnet at 2.8 times forward sales.
Clover Health Stock Surges 92.7% in Six Months, Hits New 52-Week High
Clover Health’s stock has surged 92.7% over the past six months, reaching a new 52-week high of $5.01 per share, partly driven by solid quarterly results. The company grew its sales at a 25.6% compounded annual growth rate over the last five years, outpacing the average healthcare company. Its adjusted operating margin rose by 25.6 percentage points over the same period, though it remains negative at 2.6% for the trailing 12 months. Free cash flow margin expanded by 14 percentage points over five years, reaching 2.5% for the trailing 12 months. The stock currently trades at 55.6 times forward price-to-earnings.
Jim Cramer Says Clover Health Was a Good Speculative Pick But Still Prefers UnitedHealth and CVS
Jim Cramer acknowledged that Clover Health was a good speculative pick after a caller noted the company reported GAAP profitability in Q1 2026 and guided for full-year profitability. Cramer said he was not bullish enough on the stock but remains focused on UnitedHealth and CVS for the long haul. He had previously described Clover Health as a pure speculation after a quarter where revenues were okay but earnings were not there.
CLOV · Capital · Positive Clover Health reported GAAP profitability in Q1 2026 and guided for full-year profitability, which is a positive earnings/financial event.
CMS recalculates Medicare Advantage stars after Clover lawsuit loss
The Centers for Medicare and Medicaid Services is recalculating 2026 Medicare Advantage star ratings for insurers after losing a court case over its methodology, but only plans that see their scores increase will have ratings updated and be allowed to resubmit bids. The recalculation stems from a lawsuit by Clover Health, whose largest plan dropped from 4 stars to 3.5 stars, costing the company about $120 million in bonus payments. A Georgia federal judge ordered CMS to recalculate Clover's rating without 20 disputed measures, and the agency has now voluntarily extended the recalculation to other plans, though it is removing only measures the judge ruled CMS lacked authority to collect, along with some additional unchallenged measures. TD Cowen analysts estimate that if the Clover criteria were applied broadly, UnitedHealthcare's average scores would rise from 4.11 to 4.27, a $500 million benefit, and Elevance's would move from 3.9 to 3.92, a $25 million benefit, but the current approach yields little change for most insurers. CMS noted the recalculation does not affect its right to appeal the ruling, and the move could prompt further lawsuits from insurers unhappy with their ratings.
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