Centene reports a $6.7 billion loss in 2025

Centene, a major health insurance provider, faced financial challenges in 2025, with a substantial loss of almost 500,000 Medicaid members. Despite this setback, the company experienced a promising 26% increase in enrollment within its marketplace segment, as highlighted in the fourth quarter and full-year earnings report released on February 6th.

During the fourth quarter of 2025, Centene reported total revenues of $49.7 billion, representing a significant 21.9% growth compared to the previous year. The overall revenues for the year 2025 amounted to $194.8 billion, showing a commendable increase of 19.4%.

Unfortunately, the company also disclosed a net loss of $1.1 billion for the fourth quarter, a stark contrast to the net income of $283 million reported during the same period in the preceding year. The financial report for the entire year painted a gloomy picture, revealing a substantial net loss of $6.7 billion in 2025 as opposed to a net income of $3.3 billion in 2024. This financial hit was mainly influenced by a non-cash goodwill impairment of $6.7 billion noted in the third quarter, triggered by the One Big Beautiful Bill Act, and a decline in the company’s stock prices. Additionally, Centene had to bear a $513 million impairment charge associated with the sale of its remaining Magellan Health businesses. Despite these challenges, the adjusted full-year diluted earnings per share stood at $2.08.

An essential metric to gauge Centene’s financial health, the medical loss ratio (MLR), displayed a ratio of 94.3% in the fourth quarter, contrasting with 89.6% from the corresponding period in the prior year. For the entire year of 2025, the company’s MLR stood at 91.9%, revealing a rise from 88.3% in 2024. This increase was attributed to escalating marketplace medical expenditures, Medicaid cost pressures concerning behavioral health and home health, and modifications in the Medicare prescription drug plan business.

By the end of December 31st, Centene held a total of 27.6 million at-risk members. These members were segmented into 12.5 million Medicaid members, 5.5 million marketplace members, and a collective of 1 million Medicare Advantage, and supplement plan members. Notably, the company observed growth in its Medicare PDP membership, reaching 8.1 million from 6.9 million.

Despite the challenging year of 2025, Centene has outlined expectations for the year 2026, targeting adjusted diluted earnings per share exceeding $3.00. The projected total revenues for the upcoming year fall within the range of $186.5 billion to $190.5 billion, with an MLR anticipated to be between 90.9% to 91.7%.