Centene Corp.

Centene spent 2025 repairing a business broken by Medicaid cost trend and Marketplace underpricing. The repair has beaten the plan every quarter since, with 2026 guidance raised three times — but the customer base is shrinking ahead of the 2027 policy changes. How much of the 2027 expansion membership loss is already in rates?

• The margin repair is real, and it keeps beating Centene's own plan.

  Medicaid's health ratio rose three quarters running, and 2026 rates now exceed the cost trend behind them. Marketplace went from losing money to a mid-single-digit margin after repricing. Every print has brought a higher full-year number.

• Marketplace's comeback rests on repricing and a risk-adjustment bet that paid off.

  The team refiled prices across almost all its members last summer, and the feared medical bill never arrived. Then the payment insurers make to each other for sicker members, which it expected to owe, came back as money owed to it. What share of Marketplace members are in the Silver tier now?

• Membership is shrinking faster than planned, and it changes who is left.

  Medicaid will end the year down 8% to 9%, not 6%, and Marketplace has shed about a third of its members since December. Healthier members leave first, so the money comes from rates and cost control, not more customers. How much of the improved Medicaid rate is held back for acuity?