Centene Corporation (NYSE: CNC), the self-declared leader in government-sponsored healthcare in the U.S., has taken over another state. As larger rivals like Anthem (NYSE: ANTM) and UnitedHealth Group (NYSE: UNH) quit the individual health insurance exchanges around the country, Centene has marched in. In its first major deal since July 2015, Centene is now tops in New York State, thanks to its $3.75 billion deal for not-for-profit Fidelis Care.

Fidelis Care provides health insurance coverage through Qualified Health Plans, Child Health Plus, Essential Plan, and Medicaid, available through the New York State of Health Marketplace, as well as through the Medicare Advantage, Dual Advantage, and Managed Long Term Care programs. The organization was founded in 1993 as the Catholic Health Services Plan of Brooklyn and Queens.

In the first six months of 2017, the company generated $4.8 billion in revenue, according to Centene, and Fidelis Care said its operations have been profitable.

With this acquisition, which is expected to close in early 2018, Centene adds more than 1.6 million members in New York, giving it a leadership position in the country’s four largest managed care states by membership: California, Florida, New York and Texas.

Centene intends to fund the purchase price with $2.3 billion of new equity, including share consideration, and $1.6 billion of new long-term debt. The company expects approximately $60 billion pro forma revenue in 2018, and 13.8 million members.

Centene’s more famous purchase immediately preceded the U.S. Supreme Court’s backing of Obamacare’s tax subsidies. The decision was announced in late June 2015. On July 2, Centene announced its acquisition of Health Net, Inc. (then NYSE: HNT) for $6.8 billion. The SCOTUS decision launched a wave of multi-billion-dollar mergers between Aetna (NYSE: AET) and Cigna (NYSE: CI) and Anthem and Humana (NYSE: HUM). Those were challenged by the Justice Department on antitrust grounds, and famously defeated earlier this year.

At the time, Health Net covered approximately 6 million individuals through group, individual, Medicare, Medicaid, dual eligible, U.S. Department of Defense and U.S. Department of Veterans Affairs programs. Once the transaction closed in March 2016, the combined company had more than 10 million members around the country.