UnitedHealth missed Wall Street’s second-quarter earnings expectations and offered a new and conservative take on the rest of 2025.

The health care giant said Tuesday that it expects rising medical costs, which have hurt the company and several rivals this year, to continue to pressure its performance.

The insurer says it now expects adjusted earnings of at least $16 per share in2025 after withdrawing its previous forecast for the year in May.

For the full year, analysts forecast earnings of $20.64 per share, according to the data firm FactSet.

UnitedHealth Group Inc. runs one of the nation’s largest health insurance and pharmacy benefits management businesses. The Eden Prairie, Minnesota, company also operates a growing Optum business that provides care and technology support.

In May, the company withdrew its 2025 forecast due to higher-than-expected medical costs and CEO Andrew Witty departed the company abruptly. He was replaced by Chairman Stephen Hemsley, who was the UnitedHealth CEO for more than a decade until 2017.

Hemsley promised had said in June that UnitedHealth would establish a “prudent” 2025 earnings outlook when it detailed second-quarter results.

Hemsley also said then that the company had underestimated care activity and cost trends, but improvements were being made.

In the second quarter, UnitedHealth reported adjusted earnings of $4.08 per share on $111.6 billion in revenue. Analysts expected earnings of$4.48 per share on $111.5 billion in revenue, according to FactSet.

UnitedHealth is normally the first health insurer to report earnings every quarter. But this summer, it followed competitors like Elevance Health Inc. and Centene Corp. that have lowered their annual forecasts and delivered disappointing results.

Several insurers say they have been hit by medical costs that are rising faster than expected. Companies have seen a rise in expensive emergency rooms visits and growing prescription drug costs, especially from expensive cancer treatments and gene therapy.

They’ve also seen a rise in behavioral health care, which includes the treatment of mental health conditions and substance use disorders.

Shares slid about 4% before the opening bell Tuesday.