Blue Cross Blue Shield of Minnesota posted a $353 million operating loss in 2025, driven largely by losses in its Medicare Advantage and Medicaid businesses, the insurer said April 1.
The plan paid $9.8 billion in medical and pharmacy claims last year, up $1.7 billion from 2024, on $10.4 billion in fully insured premium revenue, representing an operating margin loss of roughly 3%. The operating loss includes a $150 million premium deficiency reserve to cover claims expenses projected to exceed premium revenue going forward. Investment income offset the operating results, and the company finished the year with net income of $83 million.
Rising costs in specialty medications, including GLP-1s, and hospital inpatient services were noted as contributing to the loss. In MA, the plan cited pressure around reimbursement rates and high utilization trends. The company also absorbed a large surge of Medicare members after multiple carriers in Minnesota reduced benefits, narrowed service areas or exited the market entirely for 2026, which BCBSM said required operational and administrative expansion.
Medicaid losses stemmed from large enrollment gains in Minnesota’s Prepaid Medical Assistance Program and MinnesotaCare, the state’s low-cost coverage program for low-income residents.
Total enrollment now exceeds 3 million.
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