The Grand Roundup: BetterHelp’s cash pay collapse, Centene-Molina ACA divergence, Function’s 450M debt raise, Iowa’s managed care debate, and more

Kevin and Martin chat about a packed earnings week: Teladoc's BetterHelp cash pay business fell off a cliff in mid-May, Humana passed its 2026 MA stress test but is still terming 600,000 members from low-star plans to hit its 2028 margin target, Centene raised ACA guidance a week after Molina's "death spiral" quarter, and Centene’s Sarah London's blunt AI cost-management comments drew comparisons to Palantir's Alex Karp. Cigna, Waystar, and Alignment round out the earnings discussion.

They then move into private markets: Function raised $450 million in revenue-based financing from General Catalyst's Consumer Growth Fund, Included Health acquired Firefly Health, pairing navigation with an advanced primary care model, and Helia Health raised $14 million on a plan-optimization pitch that Martin calls a short-term arbitrage window rather than a durable business.

They close on Iowa's governor's race, where Medicaid managed care itself is on the ballot, and a broader debate about whether the country is drifting back toward fee-for-service.

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