Fitch Ratings’ outlook for the U.S. health insurance industry is stable, based on 75 percent of its insurance and managed care ratings. The agency said it anticipates the predominant rating actions to be affirmations over the next 12 to 24 months.

Fitch’s fundamental outlook for the sector is negative, though, as the Affordable Care Act could impose lower margins related to higher fees and utilization trends, as well as lower Medicare Advantage reimbursement rates, Fitch said. Those developments, however, are unlikely to erode earnings or capital positions or disrupt the competitive landscape over the next 12 to 24 months, the agency said.

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