Last Update 06 Nov 25
Fair value Increased 10%CNC: Medicaid Margin Stability And 26% ACA Premium Hike Will Shape 2026 Prospects
Centene’s analyst price target has been raised from $36 to approximately $39.76 per share. Analysts cite improving Medicaid profitability and stronger earnings guidance as key drivers for the upward revision.
Analyst Commentary
Recent commentary from Wall Street reflects a range of views on Centene’s outlook, with both positive and negative signals included in the latest round of research updates. Below is a summary of the key bullish and bearish takeaways shaping sentiment and valuation.
Bullish Takeaways- Bullish analysts have raised price targets in response to Centene’s recent quarterly outperformance. They observe that both top and bottom-line beats, along with an improvement in the consolidated health benefits ratio, have driven this optimism.
- Management’s raised guidance for fiscal year 2025, featuring increased earnings per share projections and commentary suggesting Medicaid profitability could be sustained into 2026, is viewed as a sign of strengthening core execution.
- Improved visibility on Medicare Advantage and Medicaid margins is encouraging greater confidence in the company’s medium-term growth trajectory. This comes especially after sector rotation into healthcare and positive updates on key contracts.
- Some analysts highlight opportunities for margin expansion tied to operational efficiencies and the potential return to profitability in ACA lines. These factors could support higher earnings power by 2026.
- Bearish analysts note lingering concerns over Medicaid trends, suggesting that recent deterioration could pressure earnings expectations for 2025 and 2026.
- The initiation of a Sell rating by a leading investment bank is based on the belief that the current managed care environment is facing its most significant underwriting downturn in over 15 years, indicating tougher industry conditions for Centene and its peers.
- Skepticism exists regarding the pace of recovery in both Medicaid and healthcare exchange businesses. Some suggest that margin normalization could lag behind other health insurers.
- Uncertainty about sector-wide changes to Medicare Advantage Star ratings and potential impacts on future earnings has been identified as a risk to the company’s longer-term valuation trajectory.
What's in the News
- Many Affordable Care Act plan enrollees are learning of a projected 26% average increase in premiums for 2026, impacting millions, including Centene customers (The Wall Street Journal).
- Government negotiations over enhanced subsidies for Affordable Care Act health-insurance plans are critical to resolving the current government shutdown. Subsidy expirations are looming, and nearly all Centene enrollees are affected (The Wall Street Journal).
- Federal judges in Texas and Connecticut have rejected recent challenges to the constitutionality of the Medicare Drug Price Negotiation Program. The program will continue on its current path, affecting companies such as Centene (The Hill).
Valuation Changes
- Consensus Analyst Price Target has increased from $36 to $39.76 per share, reflecting a moderate upward revision.
- Discount Rate has decreased slightly from 7.41% to 7.34%, which indicates a marginally lower assumed cost of capital.
- Revenue Growth forecast has declined from 6.5% to 5.0%. This signals tempered expectations for top-line expansion.
- Net Profit Margin estimate has risen modestly from 1.12% to 1.16%, suggesting expectations for improved profitability.
- Future P/E ratio projection has increased from 9.30x to 9.91x, implying a slight re-rating of valuation multiples.
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.



