UnitedHealth Group enters 2026 with a smaller business and faces multiple challenges.[1][2] The company announced a change in leadership when CEO Andrew Witty stepped down for personal reasons and Stephen J. Hemsley returned as CEO.[2] UnitedHealth has suspended its 2025 outlook and expects higher-than-expected health care spending, with a return to growth only in 2026.[2] The company faces rising health insurance costs and regulatory pressure, including a Justice Department investigation into not only Medicare, but also drug administration services and reimbursement practices.[5] As a result of federal subsidy expirations, UnitedHealth is returning profits from its Affordable Care Act plans directly to consumers in 2026.[1] The company expects enrollment in ACA plans to drop by about two-thirds in 2026 due to rising costs, while offering its plans in about 30 states.[1]