The late Michael N, the longtime CEO of Centene Corporation, is frequently pointed to by critics as one of the most prominent real-world figures embodying crony capitalism in health insurance. Under his nearly 30-year tenure, Neidorff grew Centene from a small $40 million regional firm into a $126 billion corporate giant.
Unlike insurance companies that relied on private, commercial markets, Neidorff’s entire business strategy relied heavily on government contracts, tax dollars, and aggressive political lobbying.
Critics argue his career illustrates crony capitalism through several distinct mechanisms:
Monetizing the Government Safety Net
While classic free markets reward businesses that provide goods directly to voluntary consumers, Neidorff built Centene by targeting government-sponsored insurance programs like Medicaid and Medicare. Centene became the largest Medicaid managed-care company in the country, meaning its revenues did not come from competing for consumer choice, but rather from securing exclusive state and federal government contracts. Critics note this created a system where profits were detached from free-market accountability.A "Pay-to-Play" Political System
To maintain and win these lucrative government contracts, Centene developed a highly sophisticated political operation. Under Neidorff, the company showered billions of dollars on political lobbying, corporate PAC contributions, and donations to both Democratic and Republican governors' associations (the very officials who oversee state Medicaid contracts). For critics of crony capitalism, this is a textbook example of a company using taxpayer-funded profits to bankroll the campaigns of the politicians who award them contracts.Exploiting Government Mandates (Obamacare)
When the Affordable Care Act (ACA) was facing existential crises and other private insurers were fleeing the marketplace exchanges due to volatility, Neidorff leaned in. He positioned Centene as an "Obamacare stalwart," heavily expanding into counties abandoned by other carriers. While framed as a public service, critics viewed this as capitalizing on a government-mandated market where the state subsidized premium payments, guaranteeing a steady flow of taxpayer money into corporate coffers.Overbilling and Regulatory Settlements
A major feature of crony capitalism is that politically connected firms often survive scandals that would bankrupt standard businesses. Near the end of Neidorff’s tenure, Centene was hit with massive lawsuits alleging that it had overbilled multiple state Medicaid programs by inflating prescription dr-g costs. Centene ultimately paid out over $1 billion to settle claims of wrongdoing across more than 20 states. Despite these severe allegations of defrauding taxpayers, states continued to renew their multi-billion-dollar contracts with the company.Massive Executive Pay from Public Funds
Neidorff routinely ranked as one of the highest-paid healthcare executives in America, sometimes taking home upwards of $25 million a year. Because Centene's revenue was primarily driven by Medicaid, this meant that executive bonuses and record-breaking corporate wealth were being funded almost entirely by tax revenues meant for low-income healthcare