Molina Healthcare (NYSE:MOH) reported second-quarter 2026 adjusted earnings per share of $1.51 on $10.2 billion of premium revenue, with management pointing to steady Medicaid performance and stronger-than-expected Medicare duals results while acknowledging continued pressure in its Marketplace business.
President and CEO Joe Zubretsky said the company’s consolidated medical care ratio, or MCR, was 92.2% in the quarter, reflecting “solid operating performance” in what he described as a challenging medical cost environment. Molina produced a 1% adjusted pre-tax margin in the quarter and a 1.3% margin year to date.
Medicaid Results Remain in Line With Expectations
In Medicaid, Molina reported a second-quarter MCR of 92.7%, which management said was in line with expectations. Zubretsky said medical cost trend remained stable and consistent with the company’s full-year guidance of 5%.
For the full year, Molina continues to expect a Medicaid MCR of 92.9%, with rate updates consistent with its 4% guidance and medical cost trend unchanged at 5%. Management said the gap between rates and trend appears to have stabilized and remains positioned to be addressed through future rate increases.
“We continue to believe that 2026 represents a trough year for Medicaid margins,” Zubretsky said, adding that the company remains optimistic about the 2027 rate-setting process as state actuaries incorporate more recent medical cost trends.
CFO Mark Keim said Medicaid’s first-half MCR of 92.4% is expected to rise to 93.3% in the second half due to normal seasonality and the implementation of the Florida CMS contract. He said any further off-cycle rate updates or early outperformance in Florida CMS would represent potential upside to 2026 guidance.
Medicare Duals Outperform, MAPD Exit Still Planned
Molina’s Medicare segment posted a second-quarter MCR of 90.7%, which was favorable to expectations. Management attributed the performance to the company’s duals products, which benefited from lower trend in several cost categories and 2026 pricing actions.
The company lowered its full-year Medicare MCR guidance to 92.2% from 94%, reflecting better performance in duals. Molina now expects Medicare to contribute $0.25 per share in 2026. That includes $1.25 per share from duals, offset by a projected $1 per share loss in its Medicare Advantage prescription drug, or MAPD, product, which the company plans to discontinue for 2027.
Zubretsky said Molina had been cautious in its initial expectations as it converted $2 billion of MMP premium to new products and added premium from RFP wins. He said early results indicate the company may reach target margins in duals sooner than originally expected.
During the question-and-answer session, management said the upside in Medicare duals was broad-based, with favorable performance in categories including inpatient, pharmacy, outpatient, emergency room, professional office visits and long-term services and supports.
Marketplace Outlook Cut on Acuity and Prior-Year Items
The company’s Marketplace business remained the main area of pressure. Molina reported a second-quarter Marketplace MCR of 88.9%, above management’s expectations. Zubretsky said the segment was affected by prior-year risk adjustment and member reconciliation items, as well as unfavorable current-year member acuity mix.
For the full year, Molina raised its Marketplace MCR guidance to 90% from 85.5%. The company reduced its Marketplace guidance by $1.50 per share, shifting from an expected gain of about $0.75 per share to a loss of $0.75 per share.
Keim said the full-year Marketplace outlook includes approximately $1 per share of losses from prior-year items and about $0.25 per share of gain from the current-year book, resulting in the $0.75 per share loss. He said the decline from prior guidance was driven by roughly $0.50 per share of prior-year items and $1 per share from a weaker current-year membership outlook.
Zubretsky said Molina entered 2026 with average Marketplace rate increases of about 30%, intended to reduce the company’s footprint and allocate less capital to the business. However, he said the company underestimated how many higher-cost members would remain with Molina as the book shrank.
“Our philosophy is until we’re convinced that the risk pool is stable in that market, we’re going to allocate less capital to it,” Zubretsky said. The company expects to reduce Marketplace exposure by approximately $1 billion in 2027, with membership concentrated in fewer states.
2027 Building Blocks and Longer-Term Targets
Molina provided preliminary commentary on 2027, saying its premium outlook is now approximately $46.5 billion, down from the $48 billion outlined at its Investor Day. The revision reflects an expected $1 billion reduction in Marketplace premium and a $500 million headwind from California’s plan to move members with undocumented immigration status from Managed Medicaid to fee-for-service.
Keim said the company’s 2027 EPS building blocks sum to more than $10 per share before considering any Medicaid MCR improvement. These include about $4.50 per share from embedded earnings, the reversal of Florida CMS implementation costs, the discontinuation of MAPD losses and operating leverage. Molina also expects Marketplace to be at least break even in 2027 as it reduces its footprint.
The company reiterated confidence in reaching $64 billion of premium revenue by 2029 and a $25 EPS target. Zubretsky said the path depends on MCR improvement in the current business, target margins from announced revenue wins and future initiatives, and operating leverage as the company grows.
Capital Position, RFPs and Regulatory Commentary
Keim said Molina ended the quarter with $290 million of parent company cash after harvesting approximately $110 million of subsidiary dividends. Operating cash flow for the first six months of 2026 was $788 million, driven by the timing of government payments in Medicaid and Marketplace. The company’s debt-to-capital ratio was about 47% at quarter-end, and Molina expects parent company cash of approximately $600 million and a debt-to-capital ratio of 44% by year-end.
Zubretsky also highlighted contract wins, including retention of a $2 billion Managed Medicaid contract in Illinois and renewal of a regional Wisconsin contract that provides additional opportunity in integrated duals. He said Molina’s historical win rate on re-procurements is now above 90%.
On regulation, Zubretsky said CMS’s interim final rule on Medicaid work requirements and biannual reverifications does not change Molina’s long-term view of enrollment reductions. The company expects membership declines to emerge gradually and result in only a minor acuity shift. Management also said it does not expect recent Medicare Stars court rulings to materially affect Molina’s business or product offerings.
About Molina Healthcare (NYSE:MOH)
Molina Healthcare, Inc is a managed care company specializing in government-sponsored health insurance programs. The company offers Medicaid managed care plans, Medicare Advantage and prescription drug plans, and individual Marketplace plans under the Affordable Care Act. Through an integrated care model, Molina emphasizes preventive and primary care services, care coordination, and disease management to improve health outcomes for its members.
The company traces its roots to the early 1980s, when Dr.
