By skyforbes 
Centene Corporation once promised a revolution in Medicaid delivery: cost savings, efficiency, and broader access to care. What it delivered instead was a consistent pattern of lawsuits, settlements, patient complaints, and broken trust. From California to Mississippi, state governments are waking up to a hard truth: outsourcing Medicaid to Centene didn’t fix their problems. It buried them.
The warnings were always there. Whistleblowers, patient advocates, and watchdogs raised alarm bells for years. But now the receipts are piling up, and the states are footing the bill.
Missouri: Centene’s Home Turf Turns Hostile
Ironically, Centene’s troubles started in its own backyard. Missouri was one of the first states to experiment with managed Medicaid in the early 2000s. Centene, then a growing player, was more than eager to take the reins. Fast forward two decades, and the state has become a legal battlefield.
In 2021, Missouri joined a multi-state investigation into Centene’s pharmacy benefit practices. By 2022, it secured part of a $1.1 billion settlement, accusing Centene of inflating drug costs and double billing taxpayers. Yet even after that, complaints about delayed services and care denials persisted.
A 2023 state audit revealed significant gaps in provider access and data accuracy. For thousands of Medicaid recipients, the promised improvements never materialized. Missouri’s regret is written in litigation, headlines, and human suffering.
Ohio: “Overbilled and Over It”
Ohio was once a shining example of public-private Medicaid collaboration. Until Centene came along.
In 2021, Ohio’s attorney general accused Centene of overcharging the state by tens of millions of dollars through its pharmacy benefit manager subsidiaries. The state eventually secured an $88 million settlement. Centene admitted no wrongdoing but quietly altered its operations.
Meanwhile, providers and patients reported systemic issues. Mental health centers complained of underpayments and administrative delays. Parents of children with chronic conditions said they had to fight to get essential treatments covered.
When asked whether the state would renew its Medicaid contract with Centene, an official said only, “We’re exploring other options.”
California: Managed Care, Mismanaged Lives
California’s Medi-Cal program is the largest Medicaid program in the United States, covering more than 15 million people. Centene’s subsidiary, Health Net, was handed significant responsibility.
In 2022, the state fined Health Net $350,000 for failing to meet standards on grievance resolution, access to care, and call center performance. That same year, investigative reports revealed that patients were being denied access to specialists despite listings in Centene’s provider directories. Those directories were later found to be riddled with inaccuracies.
The fallout was enough for California’s Department of Health Care Services to overhaul how Medi-Cal contracts are awarded. Centene’s footprint was reduced in the 2024 realignment. Trust had eroded.
Mississippi: The Settlement That Sparked a Storm
In June 2022, Mississippi quietly settled with Centene for $55 million. The reason? Allegations of pharmacy benefit overbilling, a now-familiar theme.
The settlement opened a floodgate. Other Southern states began their own reviews of Centene’s billing practices. Mississippi lawmakers, meanwhile, started questioning how one company could operate with so little oversight for so long.
Local news outlets began documenting patient horror stories. A mother whose child waited months for autism services. A diabetic who was denied coverage for a continuous glucose monitor.
Regret, in Mississippi, isn’t theoretical. It’s personal.
Arkansas, Georgia, Kansas: Buyer’s Remorse Across the Map
Arkansas suspended re-credentialing of Centene’s physicians after a flood of complaints. Georgia lawmakers launched hearings into care delays and ghost networks. Kansas, which brought Centene into its Medicaid expansion, faced provider revolts and lawsuits within a year.
Each state had its reasons for choosing Centene: budget gaps, federal pressure, or a belief in private-sector innovation. But the outcomes shared disturbing similarities: inaccessible providers, data manipulation, bureaucratic stonewalling, and relentless public relations spin.
Why States Keep Signing the Contract Anyway
If the evidence is so damning, why does Centene still operate in so many states? The answer lies in lobbying, legal muscle, and a dangerously low bar for accountability. Centene spends millions each year influencing state lawmakers and regulators. It signs nondisclosure agreements with whistleblowers. And when settlements come, they arrive without admissions of guilt.
In other words, the system rewards plausible deniability more than patient outcomes.
Conclusion: Medicaid Deserves Better
The regret expressed by states like Ohio, Missouri, California, and Mississippi isn’t just political. It reflects real harm done to vulnerable people who rely on Medicaid not as a choice, but as a lifeline.
Centene promised a revolution. What it delivered was delay, denial, and decay.
It’s time for states to reconsider not just who delivers care, but how success is measured. Dollars saved mean little when lives are compromised.