Over one-third of Centene’s marketplace members are enrolled in bronze plans, CEO Sarah London said during an April 28 earnings call.
Centene ended the previous quarter with just under 3.6 million marketplace members. Less than half are in silver plans, and the remaining share have gold coverage, Ms. London said. She added the distribution mirrors patterns in early March.
As ACA enhanced subsidies expired, many marketplace enrollees faced steeper premiums, prompting some contraction and shifts to less robust, lower-cost coverage. Ms. London cited Wakely data reflecting the change.
Overall, bronze plan enrollment surged by 10 percentage points year over year, reaching 40% of the ACA population in 2026. According to recent KFF data, only five states saw dips in bronze enrollment in 2026. Texas had the greatest bronze increase, growing that tier’s enrollment by 84%.
“When people went to sign up for coverage, they looked at their options, and they saw the higher prices. Instead of dropping coverage altogether, they selected plans with lower benefits, so they went from gold down to bronze plans or silver down to bronze plans,” a Texas Association of Health Plans spokesperson told Becker’s in March.
Ms. London said membership losses across most markets were less than expected, “which suggests that more healthy members stayed in the market in aggregate and that our pricing was appropriate relative to the overall market morbidity.”
Despite transitions, Centene had strong silver retention, with 75% of that tier’s membership stemming from renewals. Ms. London foresees “a meaningful risk adjustment offset” as Centene’s silver plans retain higher-acuity members. She added that Centene did not “go as hard at a bronze strategy.”
“In other insurance markets, the concept of adverse selection can be scary, but that’s not actually the case in [the] marketplace,” Ms. London said. “The risk adjustment mechanism is specifically designed to counteract adverse selection, and often it can actually be a profitable strategy to care for sicker members in this market.”
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