Centene Offers Staff Buyouts After Obamacare Enrollment Slump

Centene (CNC) has offered voluntary separation packages to employees across most of its workforce following steep declines in enrollment in its Affordable Care Act health plans, as the lapse of pandemic-era subsidies weighs on its commercial business.

The St. Louis-based insurer said the buyout program is designed to make the majority of its roughly 61,000 employees eligible, though it does not expect most to apply. A company spokesperson said the packages are intended to "support employees who may be considering a transition," and that the program is expected to have only an incremental effect on headcount. Bloomberg earlier reported that the move was aimed at reducing costs in Centene's ACA business.

Centene's commercial revenue fell 6% in the first quarter, driven largely by weakening ACA enrollment. Total health plan membership stood at approximately 26.3 million at the end of the period, down 6% year on year. Chief executive Sarah London said during the company's first-quarter earnings call that the decline in ACA membership had resulted in a sicker patient pool, pushing up medical costs. Shares closed down 2.75% on Monday.

The enrollment pressure reflects a broader retreat from ACA marketplaces after Congress failed to extend enhanced subsidies introduced during the COVID-19 pandemic. As those subsidies expire, many lower-income Americans are struggling to afford premiums. Centene flagged in a regulatory filing that the subsidy expiration had introduced uncertainty around 2026 enrollment.

Nationwide, sign-ups for ACA plans fell to 23 million for 2026 coverage, from 24.2 million the prior year, according to KFF data. In some states, cancellation rates have risen by as much as 200%.

In addition to its ACA business, Centene administers Medicaid plans for low-income Americans and Medicare Advantage plans for adults aged 65 and older.