Centene: Updating Estimates and Checking In on Medicaid Post-2Q Earnings

Research evidence excerpt

Centene: Updating Estimates and Checking In on Medicaid Post-2Q Earnings

John Stansel, CFA AC North America Equity Research

(1-212) 622-0083 03 August 2026 J P M O R G A N

john.stansel@jpmorgan.com

highlight the differences between Medicaid risk pools now vs. pre-redeterminations, we

think some investors may need to see MCOs prove out that acuity shifts are more manageable

next year.

Similar to other MCOs, we think CNC’s framing falls into the “manageable” category,

expecting it to exit 2026 with ~18% of Medicaid enrollment in Medicaid Expansion,

indicating some pull-forward with upbeat state commentary. With Medicaid Expansion

enrollment declining from ~20% to 18% by the end of 2026, we believe this indicates that

Medicaid Expansion enrollment is expected to decline well in excess of the overall book.

There are some moving parts to CNC’s Medicaid enrollment guidance, including the loss of

the Florida CMS contract, partially offset by the benefit from MDWise's exit in IN and

PacificSource's exit in OR (see our note here). To put this in context, if WFTC headwinds are

-MSD% over 2027-2029, this would indicate -LSD% overall Medicaid enrollment

headwinds in any given year (relatively consistent with commentary from MOH), which

would be roughly at or below the level of attrition assumed in Medicaid Expansion in

2026. Unlike the PHE, current rates benefit from elevated recent trend in the look-back base

period, plus explicit CMS guidance on mid-cycle and retro-rate adjustments and state

documentation of WFTC considerations at certification, where it appears states are providing

updates contemplating shifts in acuity from Medicaid Expansion (with commentary around

an openness to off-cycle updates from the 7/1 states). If there is a strong case for better-than-