Centene is spending more than $15 billion on rival WellCare to dive deeper into government-funded health coverage in the same week that President Donald Trump's administration renewed its attack on the Affordable Care Act.
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The insurer said Wednesday that its cash-and-stock deal to buy WellCare will create an insurer that manages Medicaid coverage for more than 12 million people and covers several million more in the federal government's Medicare program for people age 65 and older.
The deal comes after the administration attacked the ACA in court Monday, saying that former President Barack Obama's health care law should be declared unconstitutional after Congress repealed one part of it — unpopular fines on people who remain uninsured. The 2010 Affordable Care Act expanded coverage to millions of people by creating individual insurance exchanges and increasing Medicaid enrollment in several states.
Centene Corp., based in St. Louis, has built its business around Medicaid, the state and federally funded program for people who are poor or disabled, but it also has expanded aggressively on the exchanges.
The WellCare deal could help Centene improve its profitability and protect against any risks that stem from threats to the ACA, SVB Leerink analyst Ana Gupte said in a research note.
Several GOP-led states are challenging the ACA in a federal court case that may head to the Supreme Court, and the Justice Department filed a letter with a federal appeals court in New Orleans supporting their case.
Centene Chairman and CEO Michael Neidorff said Wednesday that there's a reasonable chance the law will be upheld as the case winds through federal courts. He also noted that the legal battle will take time to play out.
"We have always maintained you base your decisions at a point in time based on the facts ... known today," said.
A Centene tie up with WellCare Health Plans Inc., based in Tampa, Florida, would create an insurer with 22 million customers and a dominating Medicaid presence.
Centene pulled in about $60 billion in revenue last year, or more than five times its total from 2013. Combined, the companies estimate that they would bring in about $97 billion in revenue this year.
Like Centene, WellCare also specializes in managing Medicaid coverage. The insurer has focused in recent years on helping customers with issues outside health care like finding housing, transportation to the doctor's office or healthy food. WellCare and other insurers are focusing more on these issues because they think that keeping people healthy is a key to controlling health care costs.
Neidorff said Wednesday that the WellCare deal will help Centene with this push.
The transaction includes more than three shares of Centene stock and $120 in cash for each share of WellCare stock, or $305.39 per share. That's about a 32 percent premium to WellCare's closing price Tuesday. The companies put the deal's value at $17.3 billion.
Neidorff will lead the combined company, which will be based in St. Louis. The deal is expected to close in the first half of 2020, but it still needs approval from Centene and WellCare shareholders, as well as regulators.
Centene's acquisition bid is the latest in a string of major health care combinations announced or polished off in the past few years, as companies seek to consolidate to save money and gain more control over costs in the system. Cigna Corp. spent $52 billion to buy the pharmacy benefit manager Express Scripts, while CVS Health Corp. paid about $69 billion for the insurer Aetna.
Centene investors reacted coolly to the newest deal, sending the company's shares down more than 9 percent in midday trading, while broader indexes also slipped. WellCare shares rose more than 8 percent.
Follow Tom Murphy on Twitter: @thpmurphy