# Centene **Centene** is the largest Medicaid managed-care organization in the United States — the insurer most exposed to the public-program side of American health financing and to the politics of [[Medicaid]]. ## Scale Centene reported roughly **$163 billion in revenue (2024)** and serves about **13 million Medicaid members** across some 30 states, plus a large ACA-marketplace business under the **Ambetter** brand. Its membership swings sharply with policy: Medicaid redeterminations after the pandemic emergency cut its rolls by millions, and the scheduled expiration of enhanced ACA premium tax credits is projected to shrink Ambetter enrollment substantially. ## Why It Matters Here Centene is the canary for **coverage policy**. Because its book is concentrated in government-funded coverage — Medicaid managed care and subsidized marketplace plans — it is the corporate entity most directly affected by [[Medicaid Work Requirements]], redeterminations, and the budget fights tracked in [[Budget Hub]]. When public coverage contracts, Centene loses members and [[Safety-Net Hospital]] systems lose paying patients in the same stroke. It rounds out the payer field alongside [[UnitedHealth Group]], [[Elevance Health]], [[Humana]], [[CVS Health]], and [[Cigna]]. See [[Managed Care]] and [[Healthcare Industry Ecosystem]].