MOLINA HEALTHCARE, INC.
For the period ended Jun 30, 2025. Filed Jul 24, 2025.
View on SEC.govAbout this filing
A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.
Jun 30, 2025 · Filed Jul 24, 2025
MOH$208.99-3.5%Stored close · as of Nov 6, 2026
What changed in Management’s Discussion and Analysis?
Read the current filingPrevious report: 10-Q
Period ended 2025-03-31; filed 2025-04-24.
0001179929-25-000070
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsCurrent report: 10-Q
Period ended 2025-06-30; filed 2025-07-24.
0001179929-25-000119
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsThe baseline is this issuer’s latest earlier reporting period of the same form that was filed before the current report. A previous 10-Q is a different quarter, not a year-over-year comparison. Amendments are excluded.
Compared 168 previous paragraphs and 174 current paragraphs.
113 unchanged; 45 reworded; 15 added; 10 removed; 0 previous and 1 current paragraphs rearranged.
Tables are not compared: 4 previous and 5 current tables excluded. Dates, whitespace, punctuation and numbering changes are ignored; changes to financial figures remain significant.
A changed paragraph is not evidence that risk increased or decreased. An unchanged paragraph does not establish that risk stayed the same.
Added paragraphs (15)
Current report
SECOND QUARTER 2025 HIGHLIGHTS
Current report
•Premium revenue of $10.9 billion, which increased 15% compared with the second quarter of 2024, and mainly reflects new contract wins, acquisitions, growth in our current footprint, and rate increases;
Current report
•Consolidated medical care ratio (“MCR”) of 90.4% compared with 88.6% for the second quarter of 2024, reflecting a very challenging medical cost trend environment for each of our segments, but moderated by our effective medical cost management;
Current report
•Pre-tax margin of 2.8%.
Current report
The decline in net income in the second quarter of 2025 and six months ended June 30, 2025, when compared to the prior year, reflects a decline in operating income for both periods. The decrease in operating income was mainly attributable to an increase in the MCR, higher interest cost and lower investment income, partially offset by the benefit of higher membership and G&A expense efficiencies.
Current report
The consolidated MCR in the second quarter of 2025 increased to 90.4%, compared with 88.6% in the second quarter of 2024, or 180 basis points, and the consolidated MCR in the six months ended June 30, 2025 increased to 89.8%, compared with 88.6% MCR for the six months ended June 30, 2024, or 120 basis points. The increase in both periods reflects MCR increases in all our segments, reflecting a very challenging medical cost trend environment for each of our segments, but moderated by our consistently effective medical cost management. The consolidated MCR for the six months ended June 30, 2025 is above our long-term target range. See further discussion in “Reportable Segments—Segment Financial Performance,” below.
Current report
Investment income decreased to $106 million in the second quarter of 2025, compared with $115 million in the second quarter of 2024, and decreased to $214 million in the six months ended June 30, 2025, compared with $223 million in the six months ended June 30, 2024. The decrease was mainly attributable to a decline in interest rates, partially offset by an increase in average invested balances in each period.
Current report
The G&A expense ratio was 6.2% in the second quarter of 2025, compared with 7.0% in the second quarter of 2024. The G&A expense ratio was 6.6% in the six months ended June 30, 2025, compared with 7.1% in the six months ended June 30, 2024. The change in G&A ratios reflects reduced incentive compensation tied to lower expected performance, operating discipline, and the continued benefit of operating leverage as we grow our business.
Current report
REGULATORY DEVELOPMENTS AND RELATED TRENDS
Current report
The President signed the One Big Beautiful Bill Act (“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% on 1.3 million members in our 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 particular changes are scheduled to begin in 2028, and we expect 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. Finally, the law also limits which legal aliens may be eligible for Marketplace premium tax credits (“PTCs”), and will require pre-enrollment eligibility verification in order 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. The OBBBA also contains tax law changes affecting businesses, including modification of certain Tax Cuts & Jobs Act provisions. We are still evaluating, but do not expect the new law to have a material impact on our financial statements.
Current report
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 open enrollment period (“OEP”) starting in 2027, eliminates the special enrollment period (“SEP”) for people with incomes at or below 150% federal poverty level, and tightens eligibility verification requirements for all enrollees. HHS expects the regulation to reduce Marketplace enrollment in 2026 predominantly in states that did not expand Medicaid. Its long term impacts are uncertain as many of the provisions sunset at the end of 2026 and some do not apply to state-based Marketplaces.
Current report
Mississippi Procurement—Medicaid. Our new contract with the Mississippi Division of Medicaid commenced on July 1, 2025.
Current report
SEGMENT MEMBERSHIP
Current report
The Medicaid MCR increased 50 basis points to 91.3% in the second quarter of 2025, from 90.8% in the second quarter of 2024, and increased 60 basis points to 90.8% in the six months ended June 30, 2025, from 90.2% in the six months ended June 30, 2024. The increase in both periods was driven by higher than expected medical costs from acuity shifts, changes in product mix and an increase in utilization among our continuing population from the second half of 2024 that has continued into 2025, including high-cost drugs and behavioral health services, as well as broader utilization pressure in inpatient and outpatient settings, partially offset by premium rate increases. The Medicaid MCR for the second quarter of 2025 is above our long-term target range.
Current report
The Marketplace MCR increased to 85.4% in the second quarter of 2025, or 1,380 basis points, compared to 71.6% in the second quarter of 2024, and increased to 83.7% in the six months ended June 30, 2025, or 1,130 basis points, compared to 72.4% in the six months ended June 30, 2024. The increase in MCR for both periods was higher than expected, reflecting higher utilization relative to the risk adjustment revenue that we priced for among our continuing population and Special Enrollment Period members, prior year member reconciliations, and the impact of higher initial MCRs related to the ConnectiCare acquisition. Market indicators suggest that the overall risk pool is also significantly elevated.
Removed paragraphs (10)
Previous report
FIRST QUARTER 2025 HIGHLIGHTS
Previous report
•Premium revenue of $10.6 billion, which increased 12% compared with the first quarter of 2024 due to the premium growth in the Medicaid and Marketplace segments;
Previous report
•Consolidated medical care ratio (“MCR”) of 89.2% compared with 88.5% for the first quarter of 2024, mainly reflecting expected higher medical benefits utilization in our Medicaid segment and a higher than expected MCR in our Marketplace segment, due to certain prior period items, and a higher initial MCR related to the ConnectiCare acquisition;
Previous report
•After-tax margin of 2.7%, which was in line with our expectations.
Previous report
The change in operating income was mainly due to the impact of higher MCRs in our Medicaid and Marketplace, including the expected higher initial MCR related to new contracts, recent acquisitions and organic growth, partially offset by the impact of increased premium revenue.
Previous report
The consolidated MCR was 89.2% in the first quarter of 2025, and 88.5% in the first quarter of 2024. The results mainly reflect expected higher medical benefit utilization in our Medicaid segment, partially offset by rate increases, and a higher than expected MCR in our Marketplace segment, due to certain prior period items, and a higher initial MCR related to the ConnectiCare acquisition. These increases were partially offset by continued strong medical cost management. See further discussion in “Reportable Segments—Segment Financial Performance,” below.
Previous report
Investment income was $108 million in the first quarter of 2025, which was consistent with the first quarter of 2024.
Previous report
The G&A expense ratio was 6.9% in the first quarter of 2025, compared with 7.2% in the first quarter of 2024. The G&A ratio reflects the continued benefit of fixed cost leverage as we grow our business, and operating discipline, partially offset by new business implementation costs associated with the start of new contracts.
Previous report
The Medicaid MCR increased to 90.3% in the first quarter of 2025, from 89.7% in the first quarter of 2024, or 60 basis points, which was in line with our expectations. The increase was mainly attributable to the continued impact of higher utilization among our continuing population from the second half of 2024 that has continued into 2025, including LTSS benefits, high-cost drugs, and behavioral health services and seasonal illnesses, partially offset by rate increases.
Previous report
The Marketplace MCR increased to 81.7% in the first quarter of 2025, from 73.3% in the first quarter of 2024. The MCR reflects our product pricing strategy to achieve growth, and approximately 400 basis points related to unfavorable changes in estimate for 2024 risk adjustment, retrospective member reconciliation adjustments and the impact of higher initial MCRs related to the ConnectiCare acquisition. Excluding the prior year adjustments and ConnectiCare MCR impact, the Marketplace MCR was in line with the Company’s expectations.
Reworded paragraphs (45)
Previous wording
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, regulatory developments, business strategy, strategic transactions and commercial arrangements, membership and market growth and our objectives for future operations. Readers are cautioned not to place undue reliance on any forward-looking statements, as 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.
Current wording
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, 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 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.
Previous wording
•federal or state legislative or regulatory changes to the Medicaid, Medicare, or Marketplace programs, including potential reductions in Medicaid funding, changes to the federal matching percentage paid to states for either the Medicaid expansion or general population, block grants or per capita caps, work requirements, the reduction or elimination of provider taxes, the non-renewal of Marketplace subsidies, or the implementation of new program integrity rules, insufficient Medicare Advantage rate adjustments, or amendments of the Affordable Care Act (“ACA”);
Current wording
•federal or state legislative or regulatory changes, or changes through executive orders, to the Medicaid, Medicare, or Marketplace programs, including potential reductions in Medicaid funding, changes to the federal matching percentage paid to states for either the Medicaid expansion or general population, block grants or per capita caps, work requirements, the reduction or elimination of provider taxes, the non-renewal of Marketplace subsidies, or the implementation of new program integrity rules, insufficient Medicare Advantage rate adjustments, or amendments of the Affordable Care Act (“ACA”);
Previous wording
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 5.8 million members as of March 31, 2025, located across 22 states.
Current wording
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 5.7 million members as of June 30, 2025, located across 22 states.
Previous wording
We reported net income of $298 million, or $5.45 per diluted share, for the first quarter of 2025, which reflected the following:
Current wording
We reported net income of $255 million, or $4.75 per diluted share, for the second quarter of 2025, which reflected the following:
Previous wording
•Membership of 5.8 million at March 31, 2025 increased 25,000, or 0.4%, compared with March 31, 2024, primarily due to the growth in the Marketplace segment, including as a result of the ConnectiCare acquisition, partially offset by the impact of Medicaid redeterminations;
Current wording
•Membership of 5.7 million at June 30, 2025 increased 167,000, or 3.0%, compared with June 30, 2024, primarily due to the growth in the Marketplace segment, including the ConnectiCare acquisition, partially offset by the impact of a modest general contraction in Medicaid;
Previous wording
•General and administrative expense (“G&A”) ratio of 6.9%, compared with 7.2% for the first quarter of 2024, reflecting operating discipline and the continued benefit of fixed cost leverage as we grow our business; and
Current wording
•General and administrative expense (“G&A”) ratio of 6.2%, compared with 7.0% for the second quarter of 2024, reflecting reduced incentive compensation tied to lower expected performance, operating discipline and the continued benefit of fixed cost leverage as we grow our business; and
Previous wording
(3) After-tax margin represents net income as a percentage of total revenue.
Current wording
(3) Pre-tax margin represents income before income tax expense as a percentage of total revenue.
Previous wording
Net income in the first quarter of 2025 amounted to $298 million, or $5.45 per diluted share, compared with $301 million, or $5.17 per diluted share, in the first quarter of 2024. Operating income increased to $433 million in the first quarter of 2025, compared with $426 million in the first quarter of 2024.
Current wording
Net income in the second quarter of 2025 amounted to $255 million, or $4.75 per diluted share, compared with $301 million, or $5.17 per diluted share, in the second quarter of 2024. Net income in the six months ended June 30, 2025 amounted to $553 million, or $10.19 per diluted share, compared with $602 million, or $10.33 per diluted share, in the six months ended June 30, 2024.
Previous wording
Premium revenue increased $1,124 million, or 12%, in the first quarter of 2025, when compared with the first quarter of 2024. The higher premium revenue is due to premium growth in the Medicaid and Marketplace segments, reflecting the impact of a balanced combination of the new Medicaid contract wins, rate increases, organic growth, and the ConnectiCare acquisition, partially offset by the impact of Medicaid redeterminations. See further discussion in “Reportable Segments—Segment Financial Performance,” below.
Current wording
Premium revenue increased $1.4 billion, or 15%, in the second quarter of 2025, when compared with the second quarter of 2024, and increased $2.5 billion, or 13%, in the six months ended June 30, 2025, when compared with the six months ended June 30, 2024. The higher premium revenue reflects new contract wins, acquisitions, growth in our current footprint, and rate increases, partially offset by the impact of lower membership due to redeterminations that continued into the second half of 2024. See further discussion in “Reportable Segments—Segment Financial Performance,” below.
Previous wording
The impact of prior year reserve development in the first quarter of 2025 was not significant, and its impact on earnings was mostly absorbed by minimum MLRs and medical cost corridors.
Current wording
The impact of prior year reserve development in the six months ended June 30, 2025 was not significant, and its impact on earnings was mostly absorbed by minimum MLRs and medical cost corridors.
Previous wording
The premium tax ratio (premium tax expense as a percentage of premium revenue plus premium tax revenue) was 3.5% and 3.0% for the first quarter of 2025 and 2024, respectively. The current year ratio increase was mainly due to changes in business mix.
Current wording
The premium tax ratio (premium tax expense as a percentage of premium revenue plus premium tax revenue) was 3.8% and 3.1% for the second quarter of 2025 and 2024, respectively, and 3.7% and 3.0% for the six months ended June 30, 2025 and 2024, respectively. The current year ratio increases were mainly due to state mix changes in our Medicaid segment.
Previous wording
Other revenue amounted to $23 million in the first quarter of 2025, compared with $22 million in the first quarter of 2024. Other revenue mainly includes service revenue associated with long-term services and supports consultative services we provide in Wisconsin.
Current wording
Other revenue amounted to $22 million in the second quarter of 2025, compared with $21 million in the second quarter of 2024, and totaled $45 million in the six months ended June 30, 2025, compared with $43 million in the six months ended June 30, 2024. Other revenue mainly includes service revenue associated with long-term services and supports consultative services we provide in Wisconsin.
Previous wording
Depreciation and amortization was $48 million in the first quarter of 2025, compared with $45 million in the first quarter of 2024. The increase is due to impacts from the ConnectiCare acquisition.
Current wording
Depreciation and amortization was $58 million in the second quarter of 2025, compared with $46 million in the second quarter of 2024, and was $106 million in the six months ended June 30, 2025, compared with $91 million in the six months ended June 30, 2024. The increase is due to impacts from the ConnectiCare acquisition that closed in the first quarter of 2025.
Previous wording
Other operating expenses totaled $25 million in the first quarter of 2025 compared to $38 million in the first quarter of 2024, and the decrease compared with the first quarter of 2024 reflects certain non-recurring costs associated with acquisitions, and costs for litigation incurred in 2024. Other operating expenses also include service costs associated with long-term services and supports consultative services we provide in Wisconsin, as noted above.
Current wording
Other operating expenses decreased by $18 million in the second quarter of 2025, compared with the second quarter of 2024, and decreased by $31 million in the six months ended June 30, 2025, compared with the six months ended June 30, 2024. These decreases reflect the impact of certain non-recurring costs associated with acquisitions, and costs for litigation incurred in 2024. Other operating expenses also include service costs associated with long-term services and supports consultative services we provide in Wisconsin, as noted above.
Previous wording
Interest expense totaled $43 million in the first quarter of 2025 and was $27 million in the first quarter of 2024. The increase is due to borrowings under the Credit Facility (as defined below), the $500 million Term Loan issuance occurring in the first quarter of 2025 (as defined below), and the $750 million 6.250% Notes due 2033 that were issued in November 2024.
Current wording
Interest expense was $48 million and $28 million in the second quarter of 2025 and 2024, respectively, and $91 million and $55 million for the six months ended June 30, 2025 and 2024, respectively. The increase is due to borrowings under the Credit Facility (as defined below) and the $500 million Term Loan issuance occurring in the first quarter of 2025 (as defined below), and the $750 million 6.250% Notes due 2033 that were issued in November 2024.
Previous wording
Income tax expense amounted to $92 million in the first quarter of 2025, or 23.7% of pretax income, compared with income tax expense of $98 million, or 24.5% of pretax income in the first quarter of 2024. The difference in the effective tax rate is due to an increase in tax benefits related to transferable federal tax credits, a decrease in state and local income taxes, and differences in discrete tax benefits recognized in the respective periods.
Current wording
Income tax expense amounted to $70 million in the second quarter of 2025, or 21.5% of pretax income, compared with income tax expense of $105 million, or 25.8% of pretax income, in the second quarter of 2024. Income tax expense amounted to $162 million in the six months ended June 30, 2025, or 22.7% of pretax income, compared with income tax expense of $203 million, or 25.2% of pretax income, in the six months ended June 30, 2024. The difference in the effective tax rate for both periods is due to an increase in tax benefits related to transferable federal tax credits, decreases in nondeductible expenses and state and local income taxes, and differences in discrete tax benefits recognized in the respective periods.
Previous wording
Nevada Procurement—Medicaid. In March 2025, the Nevada Department of Health and Human Services Division of Health Care Policy and Financing (“DHCPF”) released 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, Urban Washoe, and Rural service areas. The new contract is expected to begin on January 1, 2026, and is expected to run through December 31, 2030, with one two-year extension.
Current wording
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
Previous wording
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 (“D-SNP”) to our Illinois health plan. This contract will replace the State’s Medicare-Medicaid Alignment Initiative demonstration program. The go-live date for the new contract is expected to be 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.
Current wording
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 replace the state’s Medicare-Medicaid Alignment Initiative demonstration program. The go-live date for the new contract is expected to be 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.
Previous wording
Florida Procurement—Medicaid. In July 2024, we were notified that the Florida Agency for Healthcare Administration awarded a Medicaid managed care contract to our Florida health plan. The contract commenced on February 1, 2025 and will run through December 31, 2030. We expect to serve approximately 90,000 Medicaid beneficiaries in Miami-Dade County.
Current wording
Florida Procurement—Medicaid. In July 2024, we were notified that the Florida Agency for Healthcare Administration awarded a Medicaid managed care contract to our Florida health plan. The contract commenced on February 1, 2025 and will run through December 31, 2030.
Previous wording
Wisconsin Procurement—Medicaid. In May 2024, 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 Region 5 to our Wisconsin health plan. The contract commenced on January 1, 2025, and is expected to have a duration of two years, with an option for three two-year extensions. Additionally, we were re-awarded our sole contract position in the self-directed long-term services and supports personal care program.
Current wording
Wisconsin Procurement—Medicaid. In May 2024, 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 Region 5 to our Wisconsin health plan. The contract commenced on January 1, 2025, and is expected to have a duration of two years, with an option for three two-year extensions.
Previous wording
Virginia Procurement—Medicaid. In April 2024, the Virginia Department of Medical Assistance Services (“DMAS”) issued a notice of intent to award which did not include our Virginia health plan as an awardee for its Cardinal Care Managed Care (“CCMC”) 2.0 procurement. We exercised our right to protest that decision. On April 19, 2024, DMAS upheld its notice of intent to award in response to our protest. On April 26, 2024, Molina filed a legal action in Virginia Circuit Court over DMAS’s decision not to award Molina a CCMC 2.0 contract. The state court action continues, with trial set for September 2-8, 2025. In addition, on April 1, 2025, DMAS notified us that, effective June 30, 2025, it was exercising its right to terminate Molina’s present CCMC contract and Molina’s associated Dual Eligible Special Needs contract, and that DMAS would transition Molina’s members to new plans effective July 1, 2025.
Current wording
Virginia Procurement—Medicaid. In April 2024, the Virginia Department of Medical Assistance Services (“DMAS”) issued a notice of intent to award which did not include our Virginia health plan as an awardee for its Cardinal Care Managed Care (“CCMC”) 2.0 procurement. We exercised our right to protest that decision, but DMAS upheld its issued notice of intent to award. We filed a legal action in Virginia Circuit Court over DMAS’s decision not to award a CCMC 2.0 contract to our Virginia health plan, but we withdrew such action in May 2025. As result, our contracts with DMAS terminated effective June 30, 2025.
Previous wording
As of March 31, 2025, we served approximately 5.8 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.
Current wording
As of June 30, 2025, we served approximately 5.7 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.
Previous wording
We currently have reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other.
Current wording
We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other.
Previous wording
The following table summarizes our membership by segment as of the dates indicated:
Current wording
The following table sets forth our membership by segment as of the dates indicated:
Previous wording
The following table summarizes premium revenue, medical margin, and MCR by segment for the periods indicated (dollars in millions):
Current wording
The following tables summarize premium revenue, medical margin, and MCR by segment for the periods indicated (dollars in millions):
Previous wording
Medicaid premium revenue increased $638 million, or 9%, in the first quarter of 2025, when compared with the first quarter of 2024. The increase was mainly due to revenue tied to the new contract win in New Mexico, which commenced in July 2024, expansions in Texas, which commenced in September 2024, and certain rate actions, which were partially offset by the impact of Medicaid redetermination. Also contributing to the overall premium revenue increase is a lower impact of minimum MLRs and medical cost corridors in the first quarter of 2025, when compared with the first quarter of 2024.
Current wording
Medicaid premium revenue increased $651 million, or 9%, in the second quarter of 2025, when compared with the second quarter of 2024. Medicaid premium revenue increased $1.3 billion, or 9%, in the six months ended June 30, 2025, when compared with the six months ended June 30, 2024. The increase for both periods was mainly due to revenue from the new contract win in New Mexico, which commenced in July 2024, expansions in Texas, which commenced in September 2024, and premium rate increases, which were partially offset by the impact of lower membership due to redeterminations that continued into the second half of 2024. Also contributing to the overall premium revenue increase is a lower impact of minimum MLRs and medical cost corridors in the second quarter of 2025 and six months ended June 30, 2025, when compared to the prior year.
Previous wording
The medical margin in our Medicaid program increased $16 million, or 2%, in the first quarter of 2025 when compared with the first quarter of 2024. The improvement was driven by the increased premium revenues discussed above, partially offset by an increase in the MCR, as described below.
Current wording
The medical margin in our Medicaid program increased $14 million, or 2%, in the second quarter of 2025 when compared with the second quarter of 2024, and increased $30 million, or 2%, in the six months ended June 30, 2025 when compared with the six months ended June 30, 2024. The change was driven by the increased premium revenues discussed above, partially offset by an increase in the MCR, as described below.
Previous wording
Medicare premium revenue increased $26 million, or 2%, in the first quarter of 2025 when compared to the first quarter of 2024. The increase primarily reflects membership growth associated with the ConnectiCare acquisition, partially offset by the impact of our exit from MAPD in thirteen states in 2025.
Current wording
Medicare premium revenue increased $167 million, or 12%, in the second quarter of 2025 compared to the second quarter of 2024, and increased $193 million, or 7%, in the six months ended June 30, 2025 compared to the six months ended June 30, 2024. The increase primarily reflects membership growth associated with the ConnectiCare acquisition, partially offset by the impact of our exit from MAPD in thirteen states in 2025.
Previous wording
The medical margin in Medicare increased $9 million in the first quarter of 2025, when compared with the first quarter of 2024, mainly due to the year-over-year increase in premium revenues discussed above, and the improved MCR discussed below.
Current wording
The medical margin for Medicare decreased $56 million in the second quarter of 2025, and decreased $47 million in the six months ended June 30, 2025, when compared to the same periods in 2024. The decrease in both periods was mainly due to the increase in MCR discussed below, partially offset by the year-over-year increase in premium revenues discussed above.
Previous wording
The Medicare MCR of 88.3% in the first quarter of 2025 was 40 basis points lower than the first quarter of 2024 and in line with our expectations, resulting from product pricing and benefit adjustments implemented for 2025, and the exit from MAPD in thirteen states.
Current wording
The Medicare MCR increased to 90.0% in the second quarter of 2025, or 510 basis points, compared to the second quarter of 2024, and increased to 89.2% in the six months ended June 30, 2025, or 240 basis points, compared to the six months ended June 30, 2024. The increase in each period resulted mainly from higher-than-expected utilization among our high-acuity member populations, particularly for LTSS benefits and high-cost pharmacy drugs, partially offset by pricing and benefit adjustments implemented for 2025 and the exit from MAPD in thirteen states. The Medicare MCR for the second quarter of 2025 is above our long-term target range.
Previous wording
Marketplace premium revenue in the first quarter of 2025 increased $434 million, compared with the first quarter of 2024, due to an expected increase in membership in line with our product and pricing strategy to achieve growth, membership growth associated with the ConnectiCare acquisition, and the impact of membership gained from redeterminations in 2024. Our Marketplace membership as of March 31, 2025 amounted to 662,000 members, representing an increase of 316,000 members compared to March 31, 2024.
Current wording
Marketplace premium revenue increased $573 million in the second quarter of 2025 compared to the second quarter of 2024, and increased $1.0 billion in the six months ended June 30, 2025 compared to the six months ended June 30, 2024, due to an expected increase in membership in line with our product and pricing strategy to achieve growth, membership growth associated with the ConnectiCare acquisition, and the impact of membership gained from redeterminations in 2024. Our Marketplace membership as of June 30, 2025, amounted to 690,000 members, representing an increase of 304,000 members compared to June 30, 2024.
Previous wording
The Marketplace medical margin increased $31 million in the first quarter of 2025, when compared with the first quarter of 2024, primarily due to the growth in premiums and margin associated with the higher membership, partially offset by the impact of MCR changes discussed below.
Current wording
The Marketplace medical margin decreased $3 million in the second quarter of 2025 when compared with the second quarter of 2024, and increased $28 million in the six months ended June 30, 2025 when compared with the six months ended June 30, 2024. The changes in each period were impacted by the growth in premiums and margin associated with the higher membership, and the impact of MCR changes discussed below.
Previous wording
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 2025 and 2024, respectively.
Current wording
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 for the three and six months ended June 30, 2025 and 2024.
Previous wording
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, 2025, the parent company received $110 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.”
Current wording
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 and six months ended June 30, 2025, the parent company received $260 million and $370 million, respectively, 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.”
Previous wording
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, 2025, the parent company contributed capital in the aggregate amount of $39 millionto our regulated health plan subsidiaries to satisfy statutory capital and surplus requirements and to fund our Connecticut health plans acquired in the ConnectiCare acquisition and our New Mexico health plan. 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.
Current wording
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 and six months ended June 30, 2025, the parent company contributed capital in the aggregate amount of $90 million and $129 million, respectively, to our regulated health plan subsidiaries to satisfy statutory capital and surplus requirements and to fund our Connecticut health plans acquired in the ConnectiCare acquisition and our New Mexico health plan. 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.
Previous wording
Cash, cash equivalents and investments at the parent company amounted to $191 million and $445 million as of March 31, 2025, and December 31, 2024, respectively. The decrease for the three months ended March 31, 2025, was primarily due to the purchase of approximately 1.7 million shares of our stock for $500 million in the first quarter of 2025, funding the ConnectiCare transaction for $350 million, and capital contributions to regulated health plan subsidiaries, partially offset by the timing of corporate payments, and dividends received from regulated health plan subsidiaries and net proceeds of $650 million from borrowings under the Credit Facility and Term Loan.
Current wording
Cash, cash equivalents and investments at the parent company amounted to approximately $100 million and $445 million as of June 30, 2025, and December 31, 2024, respectively. The decrease for the six months ended June 30, 2025 was primarily due to the purchase of approximately 1.7 million shares of our stock for $500 million in the first quarter of 2025, funding the ConnectiCare transaction for $350 million, and capital contributions to regulated health plan subsidiaries, partially offset by the timing of corporate payments, dividends received from regulated health plan subsidiaries and $450 million from net borrowing activity under the Credit Facility and Term Loan.
Previous wording
Net cash provided by operations for the three months ended March 31, 2025 was $190 million, compared with $214 million in the three months ended March 31, 2024. The change in cash flow mainly results from timing differences in government agency and other payables.
Current wording
Net cash used in operations for the six months ended June 30, 2025 was $112 million, compared with $5 million in the six months ended June 30, 2024. The change in cash flow mainly results from timing differences in settlement of government agency receivables and payables, including minimum MLR and medical cost corridor settlements.
Previous wording
Net cash used in investing activities was $123 million in the three months ended March 31, 2025, compared with $488 million used in the three months ended March 31, 2024, an increase in cash flow of $365 million. This change in cash flow was primarily due the net activity of proceeds and purchases of investments, which reflected net proceeds of $142 million in the three months ended March 31, 2025 and net purchases of $169 million in the three months ended March 31, 2024. Net cash paid in business combinations amounted to $245 million in the three months ended March 31, 2025, related to the ConnectiCare acquisitions, compared to $295 million in the three months ended March 31, 2024, related to the Bright acquisition.
Current wording
Net cash provided by investing activities was $5 million in the six months ended June 30, 2025, compared with $435 million used in the six months ended June 30, 2024, an increase in cash flow of $440 million. This change in cash flow reflects the net impact of proceeds and purchases of investments, which amounted to net proceeds of $296 million in the six months ended June 30, 2025 and net purchases of $88 million in the six months ended June 30, 2024. Net cash used in business combinations amounted to $245 million in the six months ended June 30, 2025, related to the ConnectiCare acquisition, compared to $295 million in net cash used in the six months ended June 30, 2024, related to the Bright acquisition.
Previous wording
Net cash provided by financing activities was $147 million in the three months ended March 31, 2025, compared with $62 million used in the three months ended March 31, 2024, an increase in cash flow of $209 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 the Credit Facility and Term Loan. In addition, in the three months ended March 31, 2025 and 2024, financing cash outflows included $36 million and $56 million, respectively, for common stock withheld to settle employee tax obligations.
Current wording
Net cash used in financing activities was $42 million in the six months ended June 30, 2025, compared with $50 million used in the six months ended June 30, 2024, an increase in cash flow of $8 million. In the six months ended June 30, 2025, financing activity included common stock purchases of $500 million and $650 million in combined borrowings under the Credit Facility and Term Loan, partially offset by $200 million in repayment under the Credit Facility and Term Loan. In addition, in the six months ended June 30, 2025 and 2024, financing cash outflows included $36 million and $56 million, respectively, for common stock withheld to settle employee tax obligations.
Previous wording
Our working capital on a consolidated basis was $5.1 billion at March 31, 2025, compared with $4.9 billion at December 31, 2024. At March 31, 2025, our cash and investments amounted to $9.6 billion, compared with $9.3 billion at December 31, 2024. 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 decreased to $36 million at March 31, 2025 compared to $75 million at December 31, 2024. We have determined that the unrealized losses primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers.
Current wording
Our working capital on a consolidated basis was $5.2 billion at June 30, 2025, compared with $4.9 billion at December 31, 2024. At June 30, 2025, our cash and investments amounted to $9.1 billion, compared with $9.3 billion at December 31, 2024. 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 decreased to $13 million at June 30, 2025 compared to $75 million at December 31, 2024. We have determined that the unrealized losses primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers.
Showing the first 40 of 45 pairs. Open the source sections for the rest.
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Current report — wording carried from elsewhere
Washoe. The new contract is expected to begin on January 1, 2026 and run through December 31, 2030, with one two-year extension.