Wolfe says Elevance Health has most conservative Medicaid enrollment guidance

Investing.com - Wolfe Research reported Thursday that Elevance Health (NYSE: ELV) maintains the most conservative guidance on Medicaid enrollment for 2026 at negative 8%, according to an updated analysis of state-level Medicaid membership data.

The firm's latest Medicaid enrollment tracker, covering March and April data, shows continued attrition across states. States updated through March showed enrollment declining 72 basis points in the month versus 57 and 58 basis points in January and February respectively.

For April, 18% of measured enrollment declined 37 basis points versus 30 basis points in March. Among 11 states providing April data, Arkansas and Indiana experienced the steepest declines at negative 2.0% month over month, while New Jersey grew 0.7% for the third consecutive month.

Wolfe estimates year-to-date enrollment declines of negative 1.7% for Elevance Health, negative 1.9% for Centene (NYSE: CNC), negative 1.3% for Molina Healthcare (NYSE: MOH), negative 1.0% for UnitedHealth Group (NYSE: UNH), negative 1.8% for CVS Health (NYSE: CVS), and negative 1.3% for Humana (NYSE: HUM) based on state footprint and current trends.

Molina Healthcare revised its same-store attrition guidance higher to 6% from 2%, driven by California, Illinois, New York and Texas. This aligns with Centene's approximately 6% year-over-year guidance and Elevance's high single-digit percentage range.

First quarter commentary across major Medicaid companies indicated stabilizing trends, with rates still running below trend and approximately 4% attrition broadly expected. Molina noted first quarter annualized figures might come in below 5%, while Centene tracked at mid-4% net trend.

All four major companies reported rates below trend, with Molina at 4% for the fiscal year, Centene at 4.5% composite, Elevance close to mid-single digits but slightly below trend, and UnitedHealth characterizing current funding as insufficient.