With the rising costs of healthcare steeply outpacing inflation, could more people afford it by investing in the sector?

That’s part of the idea behind the first two ETFs by longtime healthcare consulting firm Milliman. In November, the company filed with the Securities and Exchange Commission for the Milliman Healthcare Inflation Guard (MHIG) and Healthcare Inflation Plus (MHIP) funds. Those will be the first in a broader line of ETFs designed to help address financial risks among workers, retirees, companies, institutions and governments. The move into exchange-traded funds follows three years of work between Milliman’s life and health divisions, said Adam Schenck, principal and managing director of fund services at Milliman Financial Risk Management.

“The idea was, ‘can we turn this into some kind of investment product?’” Schenck said. “Because everybody is having trouble keeping up with healthcare expenses.”

Dissecting the Funds

Using a mix of health industry and related equities, Treasurys, TIPs, corporate bonds, commodities and liquid alternatives, MHIG “will seek to meet the healthcare costs for an average individual utilizing an employer-provided health plan in the US over time,” the company said in an announcement. The other fund, MHIP, will aim to exceed that, by allocating more of its assets to equities. The two products will use a quant model developed from Milliman’s research on the rising costs of healthcare.

There’s a prescription for this:

• The company’s own estimates put the lifetime healthcare costs for a 65-year-old couple retiring in 2025 at an average of $588,000. That’s assuming they enroll in Medicare, and the estimate doesn’t account for long-term care, dental treatments or non-prescription medications.
• Healthcare stocks struggled earlier this year, but there was a rebound last month. The S&P 500 Health Care Index is up 13% year to date, while the broader S&P 500 is up over 15%. However, the S&P 500 has vastly outperformed the healthcare index over three, five and 10 years.
• Healthcare costs have increased by 7% to 8% over the past several years, compared with 2% to 3% for the Consumer Price Index, Schenck said.

The Prognosis: The company’s work with insurance companies and government groups have shown that problems of rising costs, such as those from promising new drugs and treatments, are systemic, said Hans Leida, principal and consulting actuary at Milliman. “All of those stakeholders in one way or another grapple with those problems,” he said. But, “this is personal,” he added. “I see people in my life with needs to save for the future.”

Editor’s note: This story was updated to correct the time of the ETFs’ filing, the spelling of Adam Schenck’s name and the timeframe during which healthcare cost increases were measured.

A hundred billion is the new hundred million.

State Street’s SPYM fund surpassed $100 billion in assets last week, making it the fastest to grow from $50 billion to $100 billion, taking just 283 trading days, according to State Street. The ETF is the latest entrant to the core S&P 500 cast and represents the firm’s efforts to access growing retail markets via low fees; SPYM’s is just two basis points. But it may be the last core S&P 500 product breakthrough for a while because of all the funds already tracking the index — and their sheer size. This means advisors shouldn’t expect any new core S&P 500 funds anytime soon, experts said.

“It’s more likely that other kinds of broad equity ETFs will be launched in the future as opposed to [trying to] do battle with $100 billion ETFs that are out there,” said Loren Fox, director of research at Fuse Research Network. “At this point, it’s hard to see a lot of space in the market for another S&P 500 ETF that is just tracking the straight beta.”

4’s a Crowd

SPYM, which formerly operated under the ticker SPLG, is one of the four primary S&P 500 ETF offerings, said Aniket Ullal, head of ETF Research & Analytics at CFRA Research. The others include the iShares Core S&P 500 ETF (IVV), the Vanguard S&P 500 ETF (VOO) and the SPDR S&P 500 ETF Trust (SPY). But they cater to different segments of the market: While SPY has traditionally been a fund for institutions, such as asset managers and hedge funds, IVV has honed in on advised retail and VOO on self-directed retail investors. Because of State Street’s institutional focus, added Ullal, the company didn’t really have a product that prioritized the retail segment. “SPYM basically is their way of accessing retail money, by going with a lower-cost product and competing more directly with VOO and IVV,” he said.

Inflows and outflows among the rest of the four were varied. In Q3 2025:

• VOO brought in $6.6 billion in net inflows and is up 17.7% YTD.
• IVV added $3.6 billion in assets and is up 14.7% YTD.
• SPY, however, bled $1.7 billion and is up 15.6% YTD.

S Tier. The ETF industry as a whole, Ullal said, can also be broken down into three main price segments: the passively managed, low-cost beta tier; the mid-priced segment, which has more active management; and high-priced funds of roughly 75 basis points and above, including things like derivatives and buffer products.

“The newer entrants, like Capital Group, JPMorgan [and] Goldman Sachs, they’re focused more on active management, derivatives and those kinds of products,” Ullal said. But the low-cost segment, he added, is dominated by the likes of Vanguard, State Street and BlackRock — something he doesn’t see changing: “It’s hard to see anybody coming and disrupting these three big players.”

Marijuana may soon be reclassified as a schedule III drug, and the news has pushed cannabis ETFs, ahem, higher.

The Trump administration’s potentially friendlier stance on bud follows a similar initiative to downgrade the drug from its current schedule I status, which eventually vaporized during the Biden administration. The likely rescheduling would mean more medical research for cannabinoids, and crucially for an industry operating in a gray legal area, it could dramatically reduce taxes.

“There are some pretty big financial implications,” said Christian Magoon, CEO of Amplify ETFs. For example, companies that handle schedule I drugs can’t write off business expenses, which significantly reduces profitability, he said. Additionally, “a rescheduling starts to probably open up banking activities for many of these companies,” as many of the biggest financial institutions have avoided serving the businesses for legal reasons.

And the Green Grass Grew All Around

US cannabis ETFs primarily use swaps rather than holding marijuana stocks directly. There are only a few cannabis-focused ETFs on the market:

• The largest is the $1 billion AdvisorShares Pure US Cannabis ETF (MSOS), followed by the $193 million Amplify’s Alternative Harvest ETF (MJ), data from VettaFi show.
• Similar to other ETFs in the small category, MSOS is up by about 77% over five days, putting its year-to-date appreciation at 62%.
• Still, it was 420% higher in November 2021 than its current price of $6.50, and it’s down from its peak of $52 in February of that year. (See what we did there?)

MSOS, for example, has direct exposure to two US cannabis businesses (Curaleaf Holdings and TerrAscend Corp.). A result of the drug’s rescheduling could mean more US listings and the ability to hold them, said Mackenzie Peterson, vice president of marketing at AdvisorShares. “People have been waiting for rescheduling for a long time, and it is a catalyst we need,” she said, adding that the firm will likely continue to use swaps to increase its exposure to certain stocks in its ETFs’ portfolios.

To Be Blunt: It’s a highly volatile category due to the political uncertainty around legalization. The latest news is pushing up prices quickly, but they could fall just as fast. A secondary benefit to rescheduling the drug is that more states may work to legalize it, as some have been waiting to do, Peterson said. And the boost for medicinal use with a schedule III classification may mean that small cannabis companies suddenly become more valuable, Magoon said. “It now makes them available to be acquisition targets for consumer application companies.”