Last Update 21 Nov 25
Fair value Decreased 0.89%CNC: Margin Recovery In Medicaid And Marketplace Will Drive 2026 Earnings Upside
Centene's analyst price target has increased by $5.59 to $45.00, as analysts expect margin recovery in the Marketplace and Medicaid segments to drive accelerated earnings growth, despite ongoing near-term pressures.
Analyst Commentary
Recent research coverage of Centene highlights a mix of positive and negative outlooks, with analyst views divided over the company’s near- and medium-term trajectory. The following summarizes the prevailing themes from recent analyst commentary.
Bullish Takeaways
- Bullish analysts have raised price targets, citing strong Q3 results, upward revisions to earnings guidance, and expectations of margin recovery in both the Marketplace and Medicaid segments over the coming years.
- Improving health benefits ratios, especially with better-than-expected sequential improvement in Medicaid HBR, are seen as supportive of Centene's path to accelerated EPS growth.
- Pricing strategies are largely viewed as effectively addressing risk adjustment concerns in the Marketplace business. This increases confidence in the company’s ability to manage shifts in risk pools through 2026 and beyond.
- Longer-term outlooks anticipate normalization of Medicaid margins by 2027 to 2029, with profitability in Medicaid expected to be consistent with recent guidance.
Bearish Takeaways
- Bearish analysts caution that Centene may face ongoing earnings pressure related to deteriorating Medicaid trends and contract losses, such as the recent loss of Florida’s Children's Medical Services program. This could impact earnings power by around 3%.
- There is concern over industry-wide challenges in managed care underwriting, with some expecting the most significant downturn experienced in over 15 years. This has led to a more cautious stance on Centene’s near-term valuation.
- Some expect Medicaid margin headwinds to persist through 2026, with a longer path to recovery in both Medicaid and healthcare exchange segments. This could potentially constrain growth and valuation.
- Additional commentary suggests risk around Centene’s 2025 and 2026 earnings expectations, as adverse Medicaid developments may not be fully reflected in current outlooks.
What's in the News
- Approximately 24 million Americans enrolled in Affordable Care Act plans are seeing an average premium increase of 26% for 2026, affecting Centene and its peers in the health insurance market (Wall Street Journal).
- Enhanced subsidies for ACA health-insurance plans are set to expire by year-end. Decisions about their extension are playing a key role in ongoing government shutdown negotiations, and the outcome could directly impact Centene and other major insurers (Wall Street Journal).
- Centene announced that Ambetter will offer a variety of affordable health insurance plans in Arizona, Mississippi, and Georgia for the 2026 plan year. Open enrollment runs from November 1, 2025, through January 15, 2026.
- The company recorded a non-cash goodwill impairment charge of $6.7 billion in the third quarter of 2025.
- Centene updated its 2025 earnings guidance and is forecasting a diluted loss per share not to exceed $12.85.
Valuation Changes
- Fair Value Estimate has decreased modestly, moving from $39.76 to $39.41 per share.
- Discount Rate has risen slightly, increasing from 7.34% to 7.37%.
- Revenue Growth Expectation has fallen, changing from 4.97% to 4.66%.
- Net Profit Margin projection has declined, shifting from 1.16% to 1.01%.
- Future P/E Ratio estimate has increased notably, rising from 9.91x to 12.02x.
Key Takeaways
- Medicaid business margin recovery and strong contract wins could enhance revenue growth and market share in government health programs.
- Improved Medicare Advantage outlook, alongside commercial segment growth, supports positive revenue and earnings prospects through operational efficiencies and increased membership.
- Policy reform challenges, high medical expenses, and specialty drug costs pose risks to margins and revenue growth if not effectively managed.
Catalysts
About Centene- Operates as a healthcare enterprise that provides programs and services to under-insured and uninsured families, and commercial organizations in the United States.
- Centene's Medicaid business is expected to see margin recovery as rate adjustments align better with member acuity, which could improve Medicaid-related revenue and net margins.
- Overall strength and competitiveness in winning Medicaid contracts, such as the fully integrated D-SNP in Illinois and Medicaid expansion into rural Nevada, may drive future revenue growth and market share.
- Increased 2025 Medicare Advantage membership expectations, driven by higher retention rates, contribute to an upward revision in annual revenue, supporting earnings growth prospects.
- Plans to reach breakeven in the Medicare Advantage segment by 2027 are fortified by operational efficiencies, such as reductions in SG&A and enhancements in STARS ratings, potentially improving future net margins.
- Strong growth in the Commercial segment, primarily driven by higher-than-anticipated new enrollments and retention in Marketplace business, leads to a $5 billion increase in premium revenue guidance for 2025, which could bolster revenue and earnings.
Centene Future Earnings and Revenue Growth
Assumptions
How have these above catalysts been quantified?- Analysts are assuming Centene's revenue will grow by 7.0% annually over the next 3 years.
- Analysts assume that profit margins will shrink from 1.3% today to 1.1% in 3 years time.
- Analysts expect earnings to remain at the same level they are now, that being $2.1 billion (with an earnings per share of $4.34). However, there is a considerable amount of disagreement amongst the analysts with the most bullish expecting $2.4 billion in earnings, and the most bearish expecting $349 million.
- In order for the above numbers to justify the analysts price target, the company would need to trade at a PE ratio of 8.8x on those 2028 earnings, up from 7.4x today. This future PE is lower than the current PE for the US Healthcare industry at 21.0x.
- Analysts expect the number of shares outstanding to decline by 2.72% per year for the next 3 years.
- To value all of this in today's terms, we will use a discount rate of 7.54%, as per the Simply Wall St company report.
Centene Future Earnings Per Share Growth
Risks
What could happen that would invalidate this narrative?- Ongoing discussions around health care policy reform and the lack of broad support for major Medicaid reforms indicate potential challenges in securing favorable policy outcomes, which could impact revenue growth and net margins.
- The potential expiration of enhanced premium tax credits and complications related to the reconciliation process may affect the individual Marketplace's stability and future earnings if tax credits are not preserved.
- Influenza and influenza-like illnesses resulted in $130 million of unexpected medical expenses in Q1 2025 for Medicaid, highlighting potential volatility in medical costs that could adversely impact net margins.
- High specialty drug costs, especially in the non-low-income PDP members, present a financial risk driven by pharmaceutical industry behavior, potentially affecting future earnings and net margins if not adequately managed in future bids.
- Uncertainty surrounding Medicaid rate adjustments and ongoing discussions with state partners on rate adequacy could impact the state's ability to provide necessary rate increases and affect revenue growth and margin recovery efforts.
Valuation
How have all the factors above been brought together to estimate a fair value?- The analysts have a consensus price target of $33.562 for Centene based on their expectations of its future earnings growth, profit margins and other risk factors. However, there is a degree of disagreement amongst analysts, with the most bullish reporting a price target of $70.0, and the most bearish reporting a price target of just $24.0.
- In order for you to agree with the analyst's consensus, you'd need to believe that by 2028, revenues will be $195.6 billion, earnings will come to $2.1 billion, and it would be trading on a PE ratio of 8.8x, assuming you use a discount rate of 7.5%.
- Given the current share price of $31.06, the analyst price target of $33.56 is 7.5% higher. The relatively low difference between the current share price and the analyst consensus price target indicates that they believe on average, the company is fairly priced.
- We always encourage you to reach your own conclusions though. So sense check these analyst numbers against your own assumptions and expectations based on your understanding of the business and what you believe is probable.
How well do narratives help inform your perspective?
Disclaimer
AnalystConsensusTarget is a tool utilizing a Large Language Model (LLM) that ingests data on consensus price targets, forecasted revenue and earnings figures, as well as the transcripts of earnings calls to produce qualitative analysis. The narratives produced by AnalystConsensusTarget are general in nature and are based solely on analyst data and publicly-available material published by the respective companies. These scenarios are not indicative of the company's future performance and are exploratory in nature. Simply Wall St has no position in the company(s) mentioned. Simply Wall St may provide the securities issuer or related entities with website advertising services for a fee, on an arm's length basis. These relationships have no impact on the way we conduct our business, the content we host, or how our content is served to users. The price targets and estimates used are consensus data, and do not constitute a recommendation to buy or sell any stock, and they do not take account of your objectives, or your financial situation. Note that AnalystConsensusTarget's analysis may not factor in the latest price-sensitive company announcements or qualitative material.



