Centene ($CNC) podcast mentions
Sure. Good morning, Scott. Good to talk with you. So some, some news that I put up just late yesterday that I don't see anywhere else yet. I was able to get it confirmed with Centene that they're going to be exiting the commercial group market in California and Oregon. So that's, you know, health insurance for employers. Centene is going to be pulling out of those markets, obviously California being the biggest one. So pretty big news there. And then we could also talk about the broader trend we're seeing as we go into talking about employer health insurance. And as we go into renewal season for employers all over the country, we're seeing some of the biggest employers, so companies like Starbucks, Disney, companies like that, really paring down the benefits that they offer their employees. So things like cutting weight loss drug coverage, cutting dependent coverage, things like that. You know, I think anybody who's in the employer health benefits space knows what's coming heading into next year— double-digit rate increases, most likely. And there's a few different reasons, or a lot of different reasons for that. But it's just, it's, it's the same trend as, as always, Scott, of health insurance costs going up, but it's getting worse. And, and now we're starting to see even the most, I'd say, sophisticated health benefits programs that these private companies really be affected by that.
Jakob Emerson · Becker’s Healthcare Podcast · Payer Shakeups, Rising Costs and the Future of Employer Health Insurance with Jakob Emerson · 2026-09-04Yeah. And honestly, Scott, this is a topic we could go on about for hours. And I say that because with some of the, the estimates coming out for next year, for '27, around what is ultimately driving these costs up, you know, it's, it's none of it— some of it's not really that new. A lot of it's, you know, consolidation by the health systems, the, the pharmacy spending, like what we just talked about, behavioral health utilization, all that stuff that's not too new, but I think one factor that we're seeing cited for the first time on some of these actuarial reports is the AI documentation and the coding tools. So the AI that's listening to you in the doctor's room capturing everything you say, and then, you know, and I'm oversimplifying it, but then, you know, that going down into some kind of, the insurers call it overcoding or, you know, basically submitting claims for more care than what was delivered. And then the insurers using AI to parse through that data and deny more or make, you know, providers jump through more hoops to get paid. So all to say, the administrative issues that have been, you know, a function of the healthcare system for decades, they're getting worse because of AI. It's causing all these costs to go up. And that's now starting to come out in these reports as well. To your point, I don't know how Washington would attack that because that that is a direct result of private industry. So all to say, I, like I said, I know I could talk about this for a while, but I did want to mention the story about, um, Centene pulling out of the commercial group market in California base and Oregon and basically saying, you know, we're not gonna— we're no longer going to be selling health insurance plans to, uh, small and large employers in those two states. And I, I— it's a relatively small book of business for Centene overall. It's through their subsidiary called Health Net, uh, over on the West Coast, um, because Centene of course is a managed care giant. Their main book of business is managed Medicaid contracting with the states and ACA and a little bit of Medicare Advantage as well.
Jakob Emerson · Becker’s Healthcare Podcast · Payer Shakeups, Rising Costs and the Future of Employer Health Insurance with Jakob Emerson · 2026-09-04But what it— it's significant because it's showing that even the big players are, they're reorienting around what they know best. They're pruning away those smaller books of business that is not their core operations, even if it's in theory one of the more or in the past is one of the more revenue-generating areas. Now, you know, this company like Centene, publicly traded, is saying we're going to focus entirely on Medicaid, Medicare, and ACA. Um, we're not making any business— enough money essentially to stay open, um, in, in this area. And I don't think it's that surprising. California, probably if not the mo— if not one of them, the most competitive health insurance market in the country between Kaiser Blue Shield of California, Anthem, United, all having huge books of business there. And then I also think it's just interesting to them pulling out of Oregon. Oregon is, I would argue, going into next year, seeing one of the biggest health insurance shakeups of all the states because you've got Providence Health Plan completely shutting down. You've got Legacy Health, which is in Portland, their health plan, PacificSource, pulling out of the ACA market. And now you've got Centene pulling out of the employer market. So Oregon keeps losing all these health insurance carriers. And that's going to cause, you know, it's just going to cause a lot of disruption. Option as we go into next year.
Jakob Emerson · Becker’s Healthcare Podcast · Payer Shakeups, Rising Costs and the Future of Employer Health Insurance with Jakob Emerson · 2026-09-04