Centene Reports Huge Loss in Q2
After pulling its earnings guidance several weeks ago, Centene announced today a $253 million loss in the second quarter as it navigates significant cost pressures. Financials will be challenging in 2026 due to Exchange and Medicaid reductions in the recent budget bill. Its medical loss ratio (MLR) was 93%. It also received lower risk adjustment transfers in the Exchange than anticipated.
Through the first six months of the year, the company brought in $95.4 billion in revenue and $1.05 billion in profit. Centene will update rates for the Exchange given higher adversity and the impact of the budget bill. It also hopes for higher Medicaid rates.
Centene is the largest Exchange plan, with 5.8 million members in 29 states, and the largest Medicaid plan, with 12.8 million members in 30 states.
Additional articles: https://www.fiercehealthcare.com/payers/centene-posts-253m-loss-amid-aca-marketplace-woes and https://www.modernhealthcare.com/insurance/mh-centene-earnings-medicaid-cuts-aca-market/ and https://www.beckerspayer.com/payer/centene-posts-253m-loss-in-q2/
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#centene #medicaid #exchanges #margins
https://www.healthcaredive.com/news/centene-q2-2025-loss-medicaid-aca/754014
KHN Covers Possible Healthcare Cost Hikes For Americans
Kaiser Health News reports on the fact that President Donald Trump rode to reelection last fall on voter concerns about prices, but the budget reconciliation bill will likely increase healthcare costs dramatically. The budget bill will mean 10 million more uninsured (15 million with other changes included). Exchange premiums are set to spike enormously due to the expiration of enhanced subsidies. Other budget changes will drive up costs as well. About 6 in 10 adults — Democrats and Republicans — say they are worried about being able to afford healthcare.
#budgetreconciliation #trump #congress #medicaid #exchanges #coverage
https://kffhealthnews.org/news/article/medical-debt-trump-poilicies-little-relief/
Medicare Advantage Bills In Congress
Becker’s Payer recaps all the bill involving Medicare Advantage in Congress. The Improving Seniors’ Timely Access to Care Act has been long-stalled and deals with prior authorization. Another bill would stop so-called risk adjustment upcoding from health risk assessments and manual chart reviews as well as require the use of two years of data for risk adjustment.
#medicareadvantage #riskadjustment #overpayments
— Marc S. Ryan
