Some insurance companies are reaping spectacular profits off the taxpayer-funded Medicaid program in California, even when the state finds their patient care is subpar.

Health Net, a unit of Centene Corp., the largest Medicaid insurer nationwide, raked in $1.1 billion in profits from 2014 to 2016, according to state data obtained and analyzed by Kaiser Health News. Anthem, another industry giant, turned a profit of $549 million from California’s Medicaid program — known as Medi-Cal — in the same period.

Overall, Medicaid insurers in the Golden State made $5.4 billion in profits from 2014 to 2016, in part because the state paid higher rates during the inaugural years of the nation’s Medicaid expansion under the Affordable Care Act. California’s Medicaid director, Jennifer Kent, told Kaiser Health News she intends to recoup billions from insurers within the next year, once audits are complete and retroactive rate adjustments are made.

For more on this story, read Chad Terhune and Anna Gorman’s “Enriched By The Poor: California Health Insurers Make Billions Through Medicaid.”