Back with another NoCenteam banger, and this one hits home for me. I love old people, and I took Centene’s mission very seriously when I worked there.
I read this article and it made my blood boil.
Kudos to Kristen Hwang at CalMatters for taking the time to bring something real to the people, something besides another story about the recovery, the transformation, the margins, or changes to the business.
https://calmatters.org/health/2026/09/health-net-assisted-living-benefits-extended/
Here’s my take on what this story means through the NoCenteam lens. Fair warning: it’s longer than a page, so at least one reader may call it a “screed.” I prefer passionately calling bullsh-t when the mission and the math stop agreeing.
Let’s begin.
Sarah London recently introduced us to “Medicaid Mom.” It was a nice way to put a human face on the people behind all those membership, utilization, and margin numbers.
But Medicaid Mom gets old. Eventually she becomes Medicaid Grandma.
That's when “our most vulnerable,” “one person at a time,” “meeting members where they live,” and dignity stop being talking points and become a test.
Health Net is walking away from an assisted-living benefit serving thousands of mostly elderly, low-income Californians, many with dementia or other cognitive impairments. The problem? Too many were moving from home into assisted living instead of from nursing homes into assisted living.
In other words, get Medicaid Grandma out of a nursing home and she's a SAVINGS. Keep her from going into one in the first place and she's a COST.
Meanwhile, Centene is talking margin progression, profitability, shareholder value, and an industry-leading cost structure.
Our friend Gavin's California apparently read the mission statement. Regulators found eight deficiencies, warned of risks to member safety and continuity of care, and ordered individualized transition plans. Advocates say some members could face skilled nursing or homelessness.
So welcome to the latest transformation program:
ISP: Involuntary Senior Placement.
Because nothing says “meeting members where they live” like deciding they can’t stay there.
Maybe the spreadsheet works better for the business. Maybe the margin clears 3%. But if the business plan depends on moving vulnerable seniors out of the homes they chose, then the real cost isn't just measured in dollars. It's measured in fear, disruption, and the loss of control over the most basic decision a person has left: where they get to live.
Margins recover, share prices recover, and even reputations can be repaired. But for someone with dementia, being forced from home is not a line item or a temporary setback. It can mean losing familiarity, stability, and the last place that still feels like theirs.
Seniors deserve more than a place to be managed. They deserve the right to choose where they live and the dignity to remain there.