Molina Healthcare Inc
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Financial statements
data from SEC XBRL filings. Values are as-reported; restatements supersede originals.
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MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS (“MD&A”)
FORWARD-LOOKING STATEMENTS
This Quarterly Report on Form 10-Q (this “Form 10-Q”) contains forward-looking statements. We intend such forward-looking statements to be covered under the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act of 1933, or Securities Act, and Section 21E of the Securities Exchange Act of 1934, or Securities Exchange Act. Many of the forward-looking statements are located under the heading “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” Forward-looking statements provide current expectations of future events based on certain assumptions, and all statements other than statements of historical fact contained in this Form 10-Q may be forward-looking statements. In some cases, you can identify forward-looking statements by words such as “guidance,” “future,” “anticipates,” “believes,” “embedded,” “estimates,” “expects,” “growth,” “intends,” “plans,” “predicts,” “projects,” “will,” “would,” “could,” “can,” “may,” or the negative of these terms or other similar expressions. Forward-looking statements contained in this Form 10-Q include, but are not limited to, statements regarding our future results of operations and financial position, industry and business trends, legislative and regulatory developments and their potential impact, business strategy, strategic transactions and commercial arrangements, market and offering changes, membership, medical cost and market trends and our objectives for future operations. Readers are cautioned not to place undue reliance on any forward-looking statements, as the future is inherently unpredictable. Thus, forward-looking statements are not guarantees of future performance and the Company’s actual results may differ significantly due to numerous known and unknown risks and uncertainties.
Those known risks and uncertainties include, but are not limited to, the risk factors identified in the section titled “Risk Factors” in our 2025 Annual Report on Form 10-K, including without limitation risks related to the following matters:
•Medicaid, Medicare, or Marketplace capitation rates that are insufficient to fully cover our medical care costs and/or the rates of utilization and the health acuity status of our members, including without limitation inpatient and outpatient costs, pharmacy costs, and behavioral health care costs, and insufficient rate increases that do not keep pace with an accelerating medical care cost trend;
•federal or state legislative or regulatory changes, including changes effected by, or negative public perceptions of the Medicaid program created by, the One Big Beautiful Bill Act, or changes effected through Executive Orders, to the Medicaid, Medicare, or Marketplace programs, including potential reductions in Medicaid funding, political pressures directed at the health insurance industry regarding managed care and prior authorization practices, advocacy for and potential implementation of aspects of the so-called Great Healthcare Plan, changes to the federal matching percentage paid to states, the implementation of Medicaid work requirements, block grants or per capita caps, the reduction or elimination of provider taxes, uncertainty regarding the status or effect of Marketplace subsidies, the implementation of new program integrity rules, insufficient Medicare Advantage rate adjustments, new rules pertaining to Medicare Risk Adjustment Data Validation, or amendments of the Affordable Care Act (“ACA”);
•budget pressures on state governments and states’ efforts to reduce rates and limit rate increases to avoid budget deficits;
•evolving Marketplace dynamics including issues impacting enrollment, special enrollment periods, member choice, premium subsidies, broker rates, risk adjustment estimates and results, Marketplace plan insolvencies or receiverships, and the potential for disproportionate enrollment of higher acuity members;
•the success of our efforts to retain existing or awarded government contracts, the success of our bid submissions in response to requests for proposal, our ability to identify merger and acquisition targets to support our continued growth over time at projected levels, and our ability to realize the full amount of our embedded earnings;
•the success of the scaling up of our operations in new states in connection with request for proposal wins, and the satisfaction of all readiness review requirements under the new Medicaid contracts;
•our ability to integrate our acquisitions and realize expected benefits and limit our liabilities as projected;
•subsequent adjustments to reported premium revenue based upon subsequent developments or new information, including retroactive Medicaid rate adjustments in a state or changes to estimated amounts payable or receivable related to Marketplace risk adjustment;
•effective management of our medical costs, and the accurate estimation of incurred but not reported or paid medical costs across our health plans;
•our ability to predict with a reasonable degree of accuracy utilization rates;
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•cyber-attacks, ransomware attacks, or other privacy or data security incidents involving either ourselves or our contracted vendors, that result in an inadvertent unauthorized disclosure of protected information or operational delays;
•the ability to manage our operations, including maintaining and creating adequate internal systems and controls relating to authorizations, approvals, provider payments, and the overall success of our care management initiatives;
•operational improvements, efficiencies, and cost savings that are less than anticipated, or that result in unforeseen consequences, from our investments in artificial intelligence (“AI”) administrative tools and initiatives;
•the impact of our working in a remote work environment;
•our receipt of rates adequate to support increasing pharmacy costs, including costs associated with specialty drugs and costs resulting from formulary changes that allow the option of higher-priced non-generic drugs;
•the interpretation, implementation, and estimates of amounts owed for federal or state medical cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions and requirements;
•the interpretation and implementation of at-risk premium rules and state contract performance requirements regarding the achievement of certain quality measures, and our ability to recognize revenue amounts associated therewith;
•the transition of Medicare-Medicaid pilot programs in California, Illinois, Michigan, Ohio, South Carolina, and Texas serving those dually eligible for both Medicare and Medicaid, the increasing integration of Medicare and Medicaid programmatic and compliance requirements, and the extension or incorporation of federal Medicare requirements developed by the Centers for Medicare and Medicaid Services (“CMS”) into state-administered Medicaid programs;
•changes in our annual effective tax rate due to federal and/or state legislation, or changes in our mix of earnings and other factors;
•the efficient and effective operations of the vendors on whom our business relies;
•complications, member confusion, or enrollment backlogs related to the renewal of Medicaid coverage;
•fraud, waste and abuse matters, government audits, reviews, or investigations, comment letters, and any fine, sanction, enrollment freeze, debarment, corrective action plan, monitoring program, or premium recovery that may result therefrom;
•the success of our providers, including delegated providers, the adequacy of our provider networks, the successful maintenance of relations with our providers, the accuracy of our provider directories incidental to provider turnover and network changes, and potential medical or pharmaceutical supply shortfalls suffered by our providers incidental to the implementation of tariffs;
•approval by state regulators of dividends and distributions by our health plan subsidiaries;
•high dollar claims related to catastrophic illness;
•the favorable resolution of litigation, arbitration, or administrative proceedings consistent with our expectations;
•the greater scale and revenues of our health plans in California, New York, Texas, and Washington, and risks related to the concentration of our business in those states;
•the failure to comply with the financial or other covenants in the Credit Agreement (as defined below) or the indentures governing our outstanding senior notes;
•the availability of adequate financing on acceptable terms to fund and capitalize our expansion and growth, and to meet our general liquidity needs;
•the failure of a state in which we operate to renew its federal Medicaid waiver;
•risks associated with vaccine hesitancy and the potential for a new epidemic or pandemic, including risks presented by the flu, measles, or other contagious diseases;
•changes generally affecting the managed care industry, including any new federal or state legislation that impacts the business space in which we operate, or negative perceptions that may arise about managed care practices or government healthcare programs;
•increases in government surcharges, taxes, and assessments;
•the impact of inflation on our medical costs and the cost of refinancing our outstanding indebtedness;
•the unexpected loss of the leadership of one or more of our senior executives; and
•increasing competition and consolidation in the Medicaid or general healthcare sector.
Each of the terms “Molina Healthcare, Inc.” “Molina Healthcare,” “Company,” “we,” “our,” and “us,” as used herein, refers collectively to Molina Healthcare, Inc. and its wholly owned subsidiaries, unless otherwise stated. The forward-looking statements in this Form 10-Q are based upon information available to us as of the date of this Form 10-Q, and while we believe such information forms a reasonable basis for such statements, such information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an exhaustive
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inquiry into, or review of, all potentially available relevant information. We qualify all of our forward-looking statements by these cautionary statements. These forward-looking statements speak only as of the date of this Form 10-Q. The Company assumes no obligation to revise or update any forward-looking statements for any reason, except as required by law.
This Form 10-Q and the following discussion of our financial condition and results of operations should be read in conjunction with the accompanying consolidated financial statements and the notes to those statements appearing elsewhere in this report, and the audited financial statements and Management’s Discussion and Analysis appearing in our 2025 Annual Report on Form 10-K.
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OVERVIEW
Molina Healthcare, Inc., a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces (the “Marketplace”). We served approximately 5.0 million members as of March 31, 2026, located across 21 states.
FIRST QUARTER 2026 HIGHLIGHTS
We reported net income of $14 million, or $0.27 per diluted share, for the first quarter of 2026, which reflected the following:
•Membership of 5.0 million at March 31, 2026, which decreased 718,000, or 12%, compared with March 31, 2025, primarily due to general market contraction in Medicaid, the expiration of our Medicaid Virginia contract, and a decrease in Marketplace membership resulting from our product and pricing strategy;
•Premium revenue of $10.2 billion, which decreased 4% compared with the first quarter of 2025, reflects the impact of lower membership, partially offset by rate updates that went into effect during the quarter;
•Consolidated medical care ratio (“MCR”) of 91.1% compared with 89.2% for the first quarter of 2025, reflecting strong operating performance even as we continue to navigate a challenging medical cost environment;
•General and administrative expense (“G&A”) ratio of 7.2%, compared with 6.9% for the first quarter of 2025, due to timing of certain operating expenses; and
•Pre-tax margin of 0.3%, which was impacted by the $93 million impairment charge related to our planned exit of the MAPD product in 2027.
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CONSOLIDATED FINANCIAL SUMMARY
The following table summarizes our consolidated results of operations and other financial information for the periods indicated:
| Three Months Ended March 31, | |||||||||||||||||||
| 2026 | 2025 | ||||||||||||||||||
| (In millions, except per-share amounts) | |||||||||||||||||||
| Premium revenue | $ | 10,172 | $ | 10,628 | |||||||||||||||
| Less: medical care costs | 9,270 | 9,479 | |||||||||||||||||
| Medical margin | 902 | 1,149 | |||||||||||||||||
MCR (1) | 91.1 | % | 89.2 | % | |||||||||||||||
| Other revenues: | |||||||||||||||||||
| Premium tax revenue | 504 | 388 | |||||||||||||||||
| Investment income | 98 | 108 | |||||||||||||||||
| Other revenue | 22 | 23 | |||||||||||||||||
| General and administrative expenses | 779 | 774 | |||||||||||||||||
G&A ratio (2) | 7.2 | % | 6.9 | % | |||||||||||||||
| Premium tax expenses | 504 | 388 | |||||||||||||||||
| Depreciation and amortization | 39 | 48 | |||||||||||||||||
| Impairment | 93 | — | |||||||||||||||||
| Other | 28 | 25 | |||||||||||||||||
| Operating income | 83 | 433 | |||||||||||||||||
| Interest expense | 54 | 43 | |||||||||||||||||
| Income before income tax expense | 29 | 390 | |||||||||||||||||
| Income tax expense | 15 | 92 | |||||||||||||||||
| Net income | $ | 14 | $ | 298 | |||||||||||||||
Net income per share – Diluted | $ | 0.27 | $ | 5.45 | |||||||||||||||
| Diluted weighted average shares outstanding | 51.0 | 54.8 | |||||||||||||||||
| Other Key Statistics | |||||||||||||||||||
| Ending Membership | 5.0 | 5.8 | |||||||||||||||||
| Effective income tax rate | 52.8 | % | 23.7 | % | |||||||||||||||
Pre-tax margin (3) | 0.3 | % | 3.5 | % | |||||||||||||||
________________________
(1) MCR represents medical care costs as a percentage of premium revenue.
(2) G&A ratio represents general and administrative expenses as a percentage of total revenue.
(3) Pre-tax margin represents income before income tax expense as a percentage of total revenue.
CONSOLIDATED RESULTS
NET INCOME AND OPERATING INCOME
Net income in the first quarter of 2026 amounted to $14 million, or $0.27 per diluted share, compared with $298 million, or $5.45 per diluted share, in the first quarter of 2025. Operating income decreased to $83 million in the first quarter of 2026, compared with $433 million in the first quarter of 2025.
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The change in operating income was mainly due to the impact of lower premium revenue, the increase in MCR, and the $93 million impairment charge related to our planned exit of the MAPD product in 2027.
PREMIUM REVENUE
Premium revenue decreased $456 million, or 4%, in the first quarter of 2026, when compared with the first quarter of 2025. The lower premium revenue reflects the impact of lower Medicaid membership due to general market contraction, the expiration of our Medicaid Virginia contract, and a decrease in Marketplace membership resulting from our product and pricing strategy, partially offset by rate updates that went into effect during the quarter. See further discussion in “Reportable Segments—Segment Financial Performance,” below.
MEDICAL CARE RATIO
The consolidated MCR was 91.1% in the first quarter of 2026, and 89.2% in the first quarter of 2025. The increase reflects a higher MCR in all of our segments, reflecting strong operating performance even as we continue to navigate a challenging medical cost environment. See further discussion in “Reportable Segments—Segment Financial Performance,” below.
The impact of prior year reserve development in the first quarter of 2026 was mostly absorbed by minimum MLRs and medical cost corridors.
PREMIUM TAX REVENUE AND EXPENSES
The premium tax ratio (premium tax expense as a percentage of premium revenue plus premium tax revenue) was 4.7% and 3.5% for the first quarter of 2026 and 2025, respectively. The current year ratio increase was mainly due to state mix changes in our Medicaid segment.
INVESTMENT INCOME
Investment income was $98 million in the first quarter of 2026, compared with $108 million in the first quarter of 2025, respectively. The decrease was mainly attributable to a decline in prevailing interest rates and investment yields.
OTHER REVENUE
Other revenue amounted to $22 million in the first quarter of 2026, compared with $23 million in the first quarter of 2025. Other revenue mainly includes service revenue associated with long-term services and supports consultative services we provide in Wisconsin.
G&A EXPENSES
The G&A expense ratio was 7.2% in the first quarter of 2026, compared with 6.9% in the first quarter of 2025, due to timing of certain operating expenses, including costs to support our business growth.
DEPRECIATION AND AMORTIZATION
Depreciation and amortization was $39 million in the first quarter of 2026, compared with $48 million in the first quarter of 2025. The decrease is due to certain intangibles becoming fully amortized.
IMPAIRMENT
In the first quarter of 2026, we recognized an impairment of $93 million on intangible assets due to our strategic shift to focus exclusively on dual-eligible members in Medicare and plan to exit MAPD for 2027.
OTHER OPERATING EXPENSES
Other operating expenses totaled $28 million in the first quarter of 2026 compared to $25 million in the first quarter of 2025. Other operating expenses primarily include service costs associated with long-term services and supports consultative services we provide in Wisconsin, as noted above.
INTEREST EXPENSE
Interest expense totaled $54 million in the first quarter of 2026 and was $43 million in the first quarter of 2025. The increase is mainly attributable to the issuance of $850 million of notes in November 2025.
INCOME TAXES
Income tax expense amounted to $15 million in the first quarter of 2026, or 52.8% of pretax income, compared with income tax expense of $92 million, or 23.7% of pretax income in the first quarter of 2025. The difference in the
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effective tax rate is due to the impact of nondeductible expenses and unfavorable discrete tax items as a percentage of lower pretax income in 2026, net of a decrease in state and local income taxes.
TRENDS AND UNCERTAINTIES
LEGISLATIVE AND REGULATORY DEVELOPMENTS
One Big Beautiful Bill Act (“OBBBA”)
The President signed the OBBBA into law in July 2025, which contains changes to the Medicaid and Marketplace programs. For Medicaid, the law requires states to establish work requirements, more frequent redeterminations, and cost sharing for the Expansion program over the period from 2027 to 2029, among other modifications. These changes are expected to reduce enrollment in state Medicaid programs, but the timing and magnitude of the reductions may vary by state depending on how quickly states implement the changes, as well as macroeconomic factors since some changes are subject to suspension in case of increases in local unemployment rates. We currently estimate the reduction in enrollment will be in the range of 15% to 20% by 2029 on 1.2 million members in our Medicaid Expansion population, and any acuity shifts should be modest and gradual. An estimated two-thirds of our Expansion members already work in some capacity. The law also reduces revenues that states can raise through provider taxes to finance their share of Medicaid spending and limits payments to Medicaid providers to 100 percent of the mandated Medicare rate for Expansion states and 110 percent of the Medicare rate for non-Expansion states. These changes are scheduled to begin in 2028, and we expect they may take 5 to 15 years to be fully implemented. Their impact is uncertain at this time and will depend on how states may adapt their future tax and Medicaid funding policies in response.
The law limits which legal aliens may be eligible for Marketplace PTCs and will require pre-enrollment eligibility verification for enrollees to receive PTCs. These changes are planned to be phased in over the period from 2026 to 2028 and are expected to reduce national Marketplace enrollment as well.
Marketplace Program Integrity and Affordability Rule
In June 2025, the Department of Health and Human Services (“HHS”) finalized the Marketplace Program Integrity and Affordability Rule. The rule, among other changes, shortens the OEP starting in 2027, eliminated the special enrollment period (“SEP”) for people with incomes at or below 150% federal poverty level, and tightened eligibility verification requirements for all enrollees. Certain provisions of the Marketplace Program Integrity and Affordability Rule have been subject to legal challenges and stayed pending a final ruling. The Notice of Benefit and Payment Parameters (“NBPP”) Proposed Rule for the 2027 plan year reintroduces updated versions of certain of the stayed provisions, which could significantly impact the Marketplace if these provisions are adopted. The outcome of the legal challenges and the long term impacts of the Marketplace Program Integrity and Affordability Rule and the NBPP Proposed Rule are uncertain.
OTHER RECENT DEVELOPMENTS
RFPs and Acquisitions
Idaho Procurement—Medicaid and Medicare. Our new contract commenced on January 1, 2026.
Michigan Procurement—Medicare. Our new contract commenced on January 1, 2026 in select regions.
Massachusetts Procurement—Medicare. Our new contract commenced on January 1, 2026.
Ohio Procurement—Medicare. Our new contract commenced on January 1, 2026.
Wisconsin Procurement—Medicaid. In August 2025, the Wisconsin Department of Health Services awarded a contract to provide services under the Family Care and Family Care Partnership program in its Geographic Service Regions 2 and 7 to our Wisconsin health plan. The contract commenced on January 1, 2026 and is expected to have a duration of two years, with an option for three two-year extensions.
Nevada Procurement—Medicaid. In March 2025, the Nevada Department of Health and Human Services Division of Health Care Policy and Financing issued a notice of intent to award Medicaid and Children’s Health Insurance Program managed care contracts to our Nevada health plan. The new contract will cover Urban Clark and Urban Washoe. The new contract commenced on January 1, 2026 and will run through December 31, 2030, with one two-year extension.
Illinois Procurement—Medicare. In March 2025, the Illinois Department of Healthcare and Family Services awarded a contract to provide a Fully Integrated Dual Eligible Special Needs Plan to our Illinois health plan. This contract will
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replace the state’s Medicare-Medicaid Alignment Initiative demonstration program. The new contract commenced on January 1, 2026. The contract is expected to have an initial term of four years, with the option to extend the contract from the initial term so long as the total contract term does not exceed ten years.
Business Trends
MMP Transition—Medicare. On January 1, 2026, we successfully completed the transition of Medicare-Medicaid Plan (“MMP”) members in five states (Illinois, Michigan, Ohio, South Carolina, and Texas) to new integrated dual eligible special needs plans, which totaled $1.9 billion in total premium revenue in 2025. Our duals business will be the long-term strategic focus for our Medicare segment. As previously mentioned, we will exit the MAPD product in 2027.
Medicaid. We now expect our Medicaid enrollment to decrease in 2026, to a total of 4.5 million members by the end of the year, due to general market contraction. We previously estimated our enrollment to be flat compare to 2025. The associated revenue loss from the additional member attrition is expected to be offset by higher revenue in Marketplace, as discussed below.
Marketplace. In 2026, we are participating in the Marketplace in all our markets except Arizona, Iowa, Massachusetts, Nebraska, and New York. We now expect our Marketplace enrollment to decrease to approximately 250,000 members by the end of the year, in line with our product and pricing strategy towards restoring our target margins. The year-end membership projection is higher than the 220,000 we previously estimated, and would represent a slightly lower Marketplace premium revenue decrease in 2026 than the 50% we previously estimated.
Medicare. We continue to expect our Medicare enrollment to decrease by approximately 12% in 2026, to a total of 230,000 members by the end of the year, including 80,000 MAPD members, due to strategic positioning. In 2026, we are participating in Medicare in all our markets except Florida.
REPORTABLE SEGMENTS
As of March 31, 2026, we served approximately 5.0 million members eligible for Medicaid, Medicare, and other government-sponsored healthcare programs for low-income families and individuals, including Marketplace members, most of whom receive government premium subsidies.
We currently have reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other.
The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes long-term services and supports consultative services in Wisconsin and the commercial portion of the business acquired in connection with the ConnectiCare transaction that closed effective February 1, 2025.
HOW WE ASSESS PERFORMANCE
We derive our revenues primarily from health insurance premiums. Our primary customers are state Medicaid agencies and the federal government.
The key metrics used to assess the performance of our segments are revenue, margin and medical care ratio (“MCR”). MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying margin, or the amount earned by the segments after medical or service costs are deducted from revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer, who is our chief operating decision maker, to review results, assess performance, and allocate resources. Such oversight and decision making includes, among others, pricing, approving capital expenditures, and identifying growth opportunities. We do not report total assets by segment since this is not a metric used to assess segment performance or allocate resources.
Management’s discussion and analysis of the change in medical margin is discussed below under “Segment Financial Performance.” For more information, see Notes to Consolidated Financial Statements, Note 8, “Segments.”
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SEGMENT FINANCIAL PERFORMANCE
The following table summarizes our membership by segment as of the dates indicated:
| March 31, | December 31, | March 31, | |||||||||||||
2026 | 2025 | 2025 | |||||||||||||
| Medicaid | 4,498,000 | 4,568,000 | 4,812,000 | ||||||||||||
| Medicare | 229,000 | 262,000 | 260,000 | ||||||||||||
| Marketplace | 305,000 | 655,000 | 662,000 | ||||||||||||
| Other | 2,000 | 6,000 | 18,000 | ||||||||||||
| Total | 5,034,000 | 5,491,000 | 5,752,000 | ||||||||||||
The following table summarizes premium revenue, medical margin, and MCR by segment for the periods indicated (dollars in millions):
| Three Months Ended March 31, | |||||||||||||||||||||||||||||||||||
| 2026 | 2025 | ||||||||||||||||||||||||||||||||||
| Premium Revenue | Medical Margin | MCR | Premium Revenue | Medical Margin | MCR | ||||||||||||||||||||||||||||||
| Medicaid | $ | 7,927 | $ | 631 | 92.0 | % | $ | 8,130 | $ | 791 | 90.3 | % | |||||||||||||||||||||||
| Medicare | 1,517 | 154 | 89.8 | 1,468 | 172 | 88.3 | |||||||||||||||||||||||||||||
| Marketplace | 724 | 116 | 84.0 | 1,004 | 183 | 81.7 | |||||||||||||||||||||||||||||
| Other | 4 | 1 | 88.4 | 26 | 3 | 87.7 | |||||||||||||||||||||||||||||
| Total | $ | 10,172 | $ | 902 | 91.1 | % | $ | 10,628 | $ | 1,149 | 89.2 | % | |||||||||||||||||||||||
Medicaid
Medicaid premium revenue decreased $203 million, or 2%, in the first quarter of 2026, when compared with the first quarter of 2025. The decrease mainly reflects the impact of lower Medicaid membership due to general market contraction and the expiration of our Medicaid Virginia contract effective June 30, 2025, partially offset by rate updates that went into effect during the first quarter.
The medical margin in our Medicaid program decreased $160 million, or 20%, in the first quarter of 2026 when compared with the first quarter of 2025. The change was driven by the decreased premium revenues discussed above and the increase in the MCR, as described below.
The Medicaid MCR increased to 92.0% in the first quarter of 2026, from 90.3% in the first quarter of 2025, or 170 basis points, which reflects continued high levels of utilization, partially offset by rate updates that went into effect during the first quarter of 2026. The medical cost trend was modestly favorable to our expectations.
Medicare
Medicare premium revenue increased $49 million, or 3%, in the first quarter of 2026 when compared to the first quarter of 2025. The increase primarily reflects changes in product mix, as we transitioned MMP members into integrated duals products, and membership growth associated with the ConnectiCare acquisition that closed on February 1, 2025, partially offset by the impact of further reductions in our MAPD footprint due to our pricing strategy aimed at improving margins.
The Medicare medical margin decreased $18 million in the first quarter of 2026, when compared with the first quarter of 2025, mainly due to the increase in MCR discussed below, partially offset by the year-over-year increase in premium revenues discussed above.
The Medicare MCR of 89.8% in the first quarter of 2026 was 150 basis points higher than the first quarter of 2025. The increase was mainly attributable to the transition of MMP members into integrated duals products discussed above, partially offset by product pricing and benefit adjustments implemented for 2026. The MCR is in line with our expectations.
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Marketplace
Marketplace premium revenue in the first quarter of 2026 decreased $280 million, compared with the first quarter of 2025, due to an expected decrease in membership in line with our product and pricing strategy towards restoring our target margins. Our Marketplace membership as of March 31, 2026 amounted to 305,000 members, representing a decrease of 357,000 members compared to March 31, 2025.
The Marketplace medical margin decreased $67 million in the first quarter of 2026, when compared with the first quarter of 2025, primarily due to the decline in premium revenue discussed above and the MCR changes discussed below.
The Marketplace MCR increased to 84.0% in the first quarter of 2026, from 81.7% in the first quarter of 2025. The MCR increase mainly reflects the impact of changes in estimate for prior year risk adjustment and continued CMS program integrity initiatives.
Other
The Other segment includes service revenues and costs associated with long-term services and supports consultative services we provide in Wisconsin, the commercial portion of the business acquired in connection with the ConnectiCare transaction that closed effective February 1, 2025, and certain corporate amounts not allocated to the Medicaid, Medicare, or Marketplace segments. Such amounts were immaterial to our consolidated results of operations in the first quarters of 2026 and 2025, respectively.
LIQUIDITY, FINANCIAL CONDITION AND CAPITAL RESOURCES
LIQUIDITY
We manage our cash, investments, and capital structure to meet the short- and long-term obligations of our business while maintaining liquidity and financial flexibility. We forecast, analyze, and monitor our cash flows to enable prudent investment management and financing within the confines of our financial strategy.
We maintain liquidity at two levels: 1) the regulated health plan subsidiaries; and 2) the parent company.
Our regulated health plan subsidiaries’ primary liquidity requirements include payment of medical claims and other health care services; payment of certain settlements with our state and federal customers, such as minimum medical loss ratio and risk corridors and Marketplace risk transfers on behalf of CMS; general and administrative costs directly incurred or paid through an administrative services agreement to the parent company; and federal tax payments to the parent company under an intercompany tax sharing agreement. Our regulated health plan subsidiaries meet their liquidity needs by generating cash flows from operating activities, primarily from premium revenue; cash flows from investing activities, including investment income and sales of investments; and capital contributions received from our parent company.
Our regulated health plan subsidiaries are each subject to applicable state regulations that, among other things, require the maintenance of minimum levels of capital and surplus. We continue to maintain levels of aggregate excess statutory capital and surplus in our regulated health plan subsidiaries that we believe are appropriate. See further discussion under “Regulatory Capital and Dividend Restrictions” below. When available and as permitted by applicable regulations, cash in excess of the capital needs of our regulated health plan subsidiaries is generally paid in the form of dividends to our parent company to be used for general corporate purposes. In the three months ended March 31, 2026, the parent company received $35 million in dividends and return of capital from the regulated health plan subsidiaries. See further discussion of dividends below in “Future Sources and Uses of Liquidity—Future Sources.”
Parent company liquidity requirements generally consist of payment of administrative costs not directly incurred by our regulated operations, including, but not limited to, staffing costs, lease payments, branding and certain information technology services; capital contributions paid to our regulated health plan subsidiaries, including funding for newer health plans; capital expenditures; debt service; funding for common stock purchases, acquisitions and other growth-related activities; and federal tax payments. In the three months ended March 31, 2026, the parent company contributed capital in the aggregate amount of $15 million to our regulated health plan subsidiary in New Mexico to satisfy statutory capital and surplus requirements. Our parent company normally meets its liquidity requirements from administrative services fees earned under administrative services agreements; dividends received from our regulated subsidiaries; federal tax payments collected from the regulated subsidiaries; proceeds received from the issuance of debt and equity securities; and cash flows from investing activities, including investment income and sales of investments.
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Cash, cash equivalents and investments at the parent company amounted to approximately $213 million and $223 million as of March 31, 2026, and December 31, 2025, respectively. The change for the three months ended March 31, 2026 was primarily due to timing of certain corporate payments, partially offset by the impact of dividends received from, and contributions made to, our regulated health plan subsidiaries.
Investments
After considering expected cash flows from operating activities, we generally invest cash of regulated subsidiaries that exceeds our expected short-term obligations in longer term, investment-grade, and marketable debt securities to improve our overall investment return. These investments are made pursuant to board-approved investment policies which conform to applicable state laws and regulations.
Our investment policies are designed to provide liquidity, preserve capital, and maximize total return on invested assets, all in a manner consistent with state requirements that prescribe the types of instruments in which our subsidiaries may invest. These investment policies require that our investments have final maturities of less than 15 years, or less than 15 years average life for structured securities. Professional portfolio managers operating under documented guidelines manage our investments and a portion of our cash equivalents. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels.
The overall rating of our portfolio is AA-. Our investment policy has directives in conjunction with state guidelines to minimize risks and exposures in volatile markets. Additionally, our portfolio managers assist us in navigating the current volatility in the capital markets.
Our restricted investments are invested principally in cash, cash equivalents, U.S. Treasury securities, and corporate debt securities, and we have the ability to hold such restricted investments until maturity. All of our unrestricted investments are classified as current assets.
Cash Flow Activities
Our cash flows are summarized as follows:
| Three Months Ended March 31, | |||||||||||||||||
| 2026 | 2025 | Change | |||||||||||||||
| (In millions) | |||||||||||||||||
| Net cash provided by operating activities | $ | 1,082 | $ | 190 | $ | 892 | |||||||||||
| Net cash provided by (used in) investing activities | 11 | (123) | 134 | ||||||||||||||
| Net cash (used in) provided by financing activities | (20) | 147 | (167) | ||||||||||||||
| Net increase in cash, cash equivalents, and restricted cash and cash equivalents | $ | 1,073 | $ | 214 | $ | 859 | |||||||||||
Operating Activities
We typically receive capitation payments monthly, in advance of payments for medical claims; however, government payors may adjust their payment schedules, positively or negatively impacting our reported cash flows from operating activities in any given period. For example, government payors may delay our premium payments, or they may prepay the following month’s premium payment.
Net cash provided by operations for the three months ended March 31, 2026 was $1,082 million, compared with $190 million in the three months ended March 31, 2025. The change in cash flow mainly results from timing differences in settlement of government agency receivables and payables, including Medicaid minimum MLR and medical cost corridors, Marketplace risk adjustment and other Amounts Due to Government Agencies, partially offset by the impact of lower net income in the three months ended March 31, 2026.
Investing Activities
Net cash provided by investing activities was $11 million in the three months ended March 31, 2026, compared with $123 million used in the three months ended March 31, 2025, an increase in cash flow of $134 million. This change in cash flow reflects the net impact of proceeds and purchases of investments, which amounted to net proceeds of $46 million in the three months ended March 31, 2026 and $142 million in the three months ended March 31, 2025. Net cash paid in business combinations amounted to $245 million in the three months ended March 31, 2025, related to the ConnectiCare acquisition.
Molina Healthcare, Inc. March 31, 2026 Form 10-Q | 29
Financing Activities
Net cash used in financing activities was $20 million in the three months ended March 31, 2026, compared with $147 million provided in the three months ended March 31, 2025, a decrease in cash flow of $167 million. In the three months ended March 31, 2025, financing activity included common stock purchases of $500 million and $650 million in combined borrowings under our prior credit facility. In addition, in the three months ended March 31, 2026 and 2025, financing cash outflows included $14 million and $36 million, respectively, for common stock withheld to settle employee tax obligations.
FINANCIAL CONDITION
We believe that our cash resources, borrowing capacity available under our Credit Agreement as discussed further below in “Future Sources and Uses of Liquidity—Future Sources,” and internally generated funds will be sufficient to support our operations, regulatory requirements, debt repayment obligations and capital expenditures for at least the next 12 months.
Our working capital on a consolidated basis was $5.1 billion at both March 31, 2026 and December 31, 2025. At March 31, 2026, our cash and investments amounted to $9.6 billion, compared with $8.6 billion at December 31, 2025. A significant portion of our portfolio is held in cash and cash equivalents, and we do not anticipate the fluctuations in the aggregate fair value of our financial assets to have a material impact on our liquidity or capital position since we intend to hold our securities to maturity. Net unrealized losses on our investments classified as current and available for sale amounted to $9 million at March 31, 2026 compared to net unrealized gains of $20 million at December 31, 2025. We have determined that the unrealized losses primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers.
Because of the statutory restrictions that inhibit the ability of our health plan subsidiaries to transfer net assets to us, the amount of retained earnings readily available to pay dividends to our stockholders is generally limited to cash, cash equivalents and investments held by our unregulated parent. For more information, see the “Liquidity” discussion presented above.
Regulatory Capital and Dividend Restrictions
Each of our regulated, wholly owned subsidiaries must maintain a minimum amount of statutory capital determined by statute or regulations. Such statutes, regulations and capital requirements also restrict the timing, payment and amount of dividends and other distributions, loans or advances that may be paid to us as the sole stockholder. To the extent our subsidiaries must comply with these regulations, they may not have the financial flexibility to transfer funds to us. Based upon current statutes and regulations, the minimum capital and surplus requirement for these subsidiaries was estimated to be approximately $3.1 billion at both March 31, 2026 and December 31, 2025. The aggregate capital and surplus of our wholly owned subsidiaries was in excess of these minimum capital requirements as of both dates.
Under applicable regulatory requirements, the amount of dividends that may be paid by our wholly owned subsidiaries without prior approval by regulatory authorities as of March 31, 2026, was approximately $210 million in the aggregate. The subsidiaries may pay dividends over this amount, but only after approval is granted by the regulatory authorities.
Based on our cash and investments balances as of March 31, 2026, management believes that our regulated, wholly owned subsidiaries remain well capitalized and exceed their regulatory minimum requirements. We have the ability, and have committed, to provide additional capital to each of our health plans as necessary to ensure compliance with minimum statutory capital requirements, including new state contract wins and growth in existing states.
Debt Ratings
In April 2026, Standard & Poor’s (“S&P”) lowered the rating of our senior notes to “BB-” from “BB”. Our senior notes are currently rated “Ba2” by Moody’s Investor Service, Inc. The S&P downgrade could adversely affect our borrowing capacity and increase our borrowing costs.
Financial Covenants
Our Credit Agreement contains customary non-financial and financial covenants, including a minimum Interest Coverage Ratio and a maximum Consolidated Total Debt to Capital Ratio. Such ratios are computed as defined by the terms of the Credit Agreement.
In addition, the indentures governing each of our outstanding senior notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the
Molina Healthcare, Inc. March 31, 2026 Form 10-Q | 30
applicable indenture. As of March 31, 2026, we were in compliance with all financial and non-financial covenants under the Credit Agreement and other long-term debt.
FUTURE SOURCES AND USES OF LIQUIDITY
Future Sources
Our regulated subsidiaries generate significant cash flows from premium revenue, which is generally received a short time before related healthcare services are paid. Premium revenue is our primary source of liquidity. Thus, any decline in the receipt of premium revenue, and our profitability, could have a negative impact on our liquidity.
Dividends from Subsidiaries. When available and as permitted by applicable regulations, cash in excess of the capital needs of our regulated health plans is generally paid in the form of dividends to our unregulated parent company to be used for general corporate purposes.
Credit Agreement Borrowing Capacity. We are party to a credit agreement (the “Credit Agreement”), which provides for a revolving credit facility (“Credit Facility”) of $1.25 billion, with a lending commitment termination date of November 20, 2030. The Credit Agreement also provides for a $15 million swingline sub-facility and a $100 million letter of credit sub-facility, as well as incremental term loans available to finance certain acquisitions up to $800 million. As of March 31, 2026, we had available borrowing capacity of $1.25 billion under the Credit Facility. See further discussion in the Notes to Consolidated Financial Statements, Note 7, “Debt.”
Future Uses
Common Stock Purchases. In April 2025, our board of directors authorized the purchase of up to an additional $1 billion of our common stock. This new program extends through December 31, 2026.The exact timing and amount of any share repurchases shall be determined by management, in consultation with the Finance Committee of the Board, based on market conditions and share price, in addition to other factors, and repurchases generally will be made in accordance with the volume, price, and timing parameters under Rule 10b-18 of the Securities Exchange Act. As of April 17, 2026, $500 million remained available to purchase our common stock under this program through December 31, 2026.
Acquisitions. We have a disciplined and steady approach to growth. Organic growth, which includes leveraging our existing health plan portfolio and winning new territories, is our highest priority. In addition to organic growth, we will consider targeted acquisitions that are a strategic fit that we believe will leverage operational synergies, and lead to incremental earnings accretion.
Regulatory Capital Requirements and Dividend Restrictions. We have the ability, and have committed, to provide additional capital to each of our health plans as necessary to ensure compliance with minimum statutory capital requirements, including new state contract wins and growth in existing states.
CONTRACTUAL OBLIGATIONS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 2025 was disclosed in our 2025 Annual Report on Form 10-K.
There were no significant changes to our contractual obligations and commitments not otherwise disclosed or outside the ordinary course of business during the three months ended March 31, 2026.
CRITICAL ACCOUNTING ESTIMATES
When we prepare our consolidated financial statements, we use estimates and assumptions that may affect reported amounts and disclosures. Actual results could differ from these estimates, and some differences could be material. Our most significant accounting estimates, which include a higher degree of judgment and/or complexity, include the following:
•Medical costs, claims and benefits payable. Refer to Notes to Consolidated Financial Statements, Note 6, “Medical Claims and Benefits Payable,” for a table that presents the components of the change in medical claims and benefits payable, and for additional information regarding the factors used to determine our changes in estimates for all periods presented in the accompanying consolidated financial statements. Other than the discussion as noted above, in the three months ended March 31, 2026 there were no significant changes to our disclosure reported in “Critical Accounting Estimates” in our 2025 Annual Report on Form 10-K.
Molina Healthcare, Inc. March 31, 2026 Form 10-Q | 31
•Premium Revenue Recognition and Amounts Due Government Agencies: Risk Adjustment. For a discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Notes to Consolidated Financial Statements, Note 2, “Significant Accounting Policies.”
•Business Combinations, and Goodwill and intangible assets, net. In the three months ended March 31, 2026, there were no significant changes to our disclosure reported in “Critical Accounting Estimates” in our 2025 Annual Report on Form 10-K.
Next expected filings
- ~2026-07-23 10-Q expected by 2026-08-07 (in 83 days)
- ~2026-10-22 10-Q expected by 2026-11-06 (in 174 days)
- ~2027-02-09 10-K expected by 2027-02-25 (in 284 days)
- ~2027-04-22 10-Q expected by 2027-05-07 (in 356 days)
Predicted from historical filing cadence; not an SEC commitment.
Recent SEC filings
- 2026-04-23 10-Q Quarterly Report
- 2026-04-22 8-K Earnings Release; Financial Statements and Exhibits
- 2026-02-10 10-K Annual Report
- 2026-02-06 8-K Material Agreement Entered; Material Financial Obligation; Material Impairments; Financial Statements and Exhibits
- 2026-02-05 8-K Earnings Release; Financial Statements and Exhibits
- 2025-11-20 8-K Material Agreement Entered; Material Financial Obligation; Other Events; Financial Statements and Exhibits
- 2025-10-23 10-Q Quarterly Report
- 2025-10-22 8-K Earnings Release; Financial Statements and Exhibits
- 2025-08-12 8-K Material Agreement Entered; Material Financial Obligation; Financial Statements and Exhibits
- 2025-07-24 10-Q Quarterly Report
- 2025-07-23 8-K Earnings Release; Financial Statements and Exhibits
- 2025-07-07 8-K Earnings Release; Financial Statements and Exhibits
- 2025-05-01 8-K Officer/Director Change; Shareholder Vote Results; Financial Statements and Exhibits
- 2025-04-24 10-Q Quarterly Report
- 2025-04-23 8-K Earnings Release; Financial Statements and Exhibits