(Bloomberg) — UnitedHealth Group Inc., the biggest U.S. health insurer, reported a first-quarter profit decline that was less than analysts’ estimates as higher enrollment helped blunt the effect of increased medical costs. The company reiterated its full-year forecast.

Net income fell 14% to $1.19 billion, or $1.16 a share, from $1.39 billion, or $1.31, a year earlier, the Minnetonka, Minnesota-based company said today in a statement. The per-share earnings beat by 2 cents the average of 21 analysts’ estimates compiled by Bloomberg. Revenue rose 11%to $30.3 billion.

UnitedHealth hasn’t missed analysts’ profit estimates in four years as earnings have been helped by an economic outlook that discouraged Americans from seeking medical care. Insurers have scaled back premium increases this year, in part to reflect those lower costs, says Carl McDonald, a Citigroup analyst in New York.

 “United, like many plans, is pricing much closer to cost trend in 2013 than has been the case in prior years,” limiting the potential for earnings gains, McDonald says.

UnitedHealth also faced a difficult comparison with last year’s quarter, when it recorded $530 million in savings for medical claims that were lower than expected, McDonald says.

The company, the first health insurer to report earnings this quarter, reaffirmed its expectations for 2013 earnings of $5.25 a share to $5.50 a share. The average of analysts’ estimates had been $5.52 a share.

UnitedHealth fell 1.2% to $62.03 in New York trading yesterday. The shares have gained 14% this year.

The financial results will probably matter less to investors than the outlook for next year, says Matthew Borsch, a Goldman Sachs Group Inc. analyst in New York. Worries about how President Barack Obama’s Affordable Care Act will affect insurers may keep a lid on the shares, he told clients in an April 16 note.

 “At this point, we think investors will wait for the ‘proof in the pudding’ showing that reform will be manageable,” he says.

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