Louisiana moves to sever its Medicaid deal with UnitedHealthcare, redirecting about 345,000 enrollees to other plans just weeks before a new agreement was set to start next year. The state’s Department of Health (LDH) announced that individuals on the UnitedHealthcare plan will be reassigned to alternate Medicaid Managed Care options. In a December 2 letter, Medicaid Director Seth Gold informed the insurer that LDH would not renew the contract, which runs through December 31.
The letter states: “LDH will begin the transition process of moving your Medicaid members to other contracted Medicaid Managed Care Plans for a January 1, 2026 effective date. We expect United to continue to abide by all of the terms of its current contract with LDH through the expiration date. We also expect your full cooperation with transitioning your members to their new Medicaid Managed Care Plans.” However, the document does not specify the rationale behind this decision.
Louisiana currently collaborates with six insurers to provide coverage for low-income residents through Medicaid. UnitedHealthcare’s contract is the second-largest among these. Projections for the 2026 calendar year estimate the contract at roughly $4.2 billion and cover 344,614 plan members, based on mid-November data presented by LDH to lawmakers.
There were early hints of broader reconsideration: local reporting from the Louisiana Illuminator suggested that another contract with Aetna (CVS Health) could also be terminated, a one-year arrangement valued at about $1.9 billion covering 165,163 individuals. Nevertheless, LDH subsequently announced renewal with Aetna Better Health of Louisiana for 2026.
A December 9 letter from the Medicaid director confirms: after talks with Aetna Better Health of Louisiana, LDH will renew the Aetna contract as a Medicaid Managed Care Organization for Louisiana for calendar year 2026.
The UnitedHealthcare decision appears to have been finalized recently. At a November 20 legislative hearing, Health Secretary Bruce Greenstein and other health officials asked lawmakers to extend all six Medicaid contracts, including UnitedHealthcare and Aetna, with no indication of any forthcoming terminations.
This story is developing and updates will follow as more details emerge.
