By skyforbes 
Medicaid patients enter the system expecting that once their treatment is approved, they will finally receive the care they need. But under Centene, approval is rarely the end of the story. It is the beginning of a cycle. Patients find themselves forced to reapply for the same medications, therapies, and procedures again and again, until exhaustion or worsening health breaks them.
This is not a paperwork accident. It is a deliberate strategy that saves Centene money by trapping patients in what can only be called the loop of denial.
Approvals That Expire
On paper, Centene authorizes coverage for treatments ranging from chemotherapy to physical therapy. In practice, these approvals are often temporary. A patient may receive coverage for only a short period, after which the authorization expires and the entire process begins again.
Doctors resubmit forms. Patients wait. Weeks pass, sometimes months. Care is interrupted. Conditions worsen. Families who thought they had cleared the hurdle discover that the finish line has moved further away.
For Centene, every gap is profit. Every delay means fewer claims paid.
Exhaustion as a Tactic
Families living with chronic illness describe the process as a war of attrition. Parents of children with disabilities report resubmitting the same paperwork multiple times a year for therapies their children will always need. Cancer patients recount delays in treatment as authorizations lapse mid-regimen.
The system is designed to wear people down. Many patients eventually stop fighting. Some pay out of pocket until they can no longer afford it. Others forgo care entirely.
Centene calls this process “utilization management.” Patients call it obstruction.
Providers Under Siege
The loop of denial does not just burden patients. Providers are forced into endless cycles of resubmission, diverting time and staff resources from actual care. Clinics assign entire employees to manage Centene paperwork. Small practices cannot absorb the cost and are often pushed out of Medicaid altogether.
Each re-application cycle increases administrative strain while lowering reimbursement. The very providers who should be focused on treating patients instead become unpaid clerks for a bureaucracy designed to grind them down.
The Human Toll
Behind the paperwork are real lives. A child with autism losing therapy hours because his authorization lapsed. An elderly woman missing dialysis treatments while waiting for a new approval. A man with multiple sclerosis forced to interrupt medication because Centene required another round of paperwork.
Every story follows the same pattern. Approval is never final. The system forces patients back into the maze, and each delay carries health consequences that cannot be undone.
Why Oversight Fails
Regulators see denials and appeals. What they do not track is repetition. Centene can report that authorizations are granted while hiding the fact that they are repeatedly set to expire, forcing re-application. To the state, the company looks compliant. To the patient, the system is chaos.
The absence of oversight allows Centene to present itself as both efficient and fair while running a system that depends on endless re-submissions.
Breaking the Loop
The solution is not complicated. Chronic conditions should not require constant re-authorization. Lifelong therapies should not be treated as temporary luxuries. Regulators should require contractors to streamline approvals for conditions that do not change, and contracts should penalize companies that repeatedly force patients through unnecessary hurdles.
Until such safeguards exist, Centene will continue to profit from the loop of denial, counting on fatigue and frustration to do what outright denials cannot.
Conclusion: A System Built to Break Patients
Medicaid was created to provide stability for people living with poverty, disability, and chronic illness. Under Centene, that stability collapses into a cycle of re-applications and rejections that erodes trust and endangers lives.
The loop of denial is not a side effect of bureaucracy. It is the business model. Each forced re-application saves Centene money while pushing patients closer to despair. Until regulators recognize and confront this tactic, the company will keep turning care into a revolving door, with patients left circling endlessly, waiting for help that never fully arrives.