Centene Corporation

Liquidity and leverage: at 9/30/25, total debt was about $17.6 billion; unregulated cash and investments were roughly $1.3 billion, with ample regulated liquidity within subsidiaries. Debt-to-capital rose to 45.5% in Q3 due to the goodwill impairment. Revolver capacity and laddered senior notes provide flexibility.

Operating cash flow recovered strongly in 2025 (nine months CFO ≈ $4.65 billion; Q3 alone ≈ $1.36 billion), reversing 2024’s working-capital headwinds tied to PBM transition and Marketplace risk-adjustment timing. However, regulated capital requirements limit fungibility of cash, and adverse utilization spikes can compress cash generation.

Net assessment: balance sheet manageable for a scale payer, with meaningful but acceptable financial risk.