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1. Company Snapshot

1.a. Company Description

Molina Healthcare, Inc.provides managed health care services to low-income families and individuals under the Medicaid and Medicare programs and through the state insurance marketplaces.It operates in four segments, Medicaid, Medicare, Marketplace, and Other.


As of December 31, 2021, the company served the company served approximately 5.2 million members eligible for Medicaid, Medicare, and other government-sponsored healthcare programs in 18 states.The company was founded in 1980 and is headquartered in Long Beach, California.

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1.b. Last Insights on MOH

Molina Healthcare's recent performance has been negatively impacted by significant cost pressures and underperformance. The company's Q3 2025 earnings report, released on October 23, 2025, revealed a 69% plunge in earnings due to rising medical and administrative costs. This led to a guidance cut for the third time this year. Investigations into potential securities law violations have been launched by firms such as Levi & Korsinsky and Bleichmar Fonti & Auld LLP. Rising medical costs and weaker investment income have also affected profitability.

1.c. Company Highlights

2. Molina Healthcare's Q3 2025 Earnings: A Challenging Medical Cost Environment

Molina Healthcare reported a below-expectations third-quarter performance, with adjusted earnings per share of $1.84 on $10.8 billion of premium revenue, significantly missing the estimated $3.97 EPS. The company's consolidated medical cost ratio (MCR) stood at 92.6%, reflecting the continuation of a challenging medical cost environment. The MCR was higher than expected, driven by utilization of behavioral health, pharmacy, long-term services and supports, and inpatient care.

Publication Date: Oct -27

📋 Highlights
  • Q3 2025 Underperformance:: Adjusted EPS of $1.84, $10.8B premium revenue, and 92.6% consolidated MCR due to elevated medical costs.
  • Medicaid Margin Pressure:: 92% MCR (2.6% margin) driven by higher behavioral health, pharmacy, and inpatient care utilization, below expectations.
  • 2025 Guidance Revision:: Full-year EPS cut to $14/share, 91.3% MCR, with Medicaid at 3.2% margin and Medicare at breakeven.
  • 2026 Growth Targets:: $46B revenue outlook from Medicaid expansions in Georgia/Texas, duals growth, and M&A pipeline of $54B in opportunities.
  • Marketplace Strategy Shift:: 95.6% MCR in Q3; exiting 20% of counties, raising rates 30–45%, and reducing exposure to achieve breakeven in 2026.

Segment Performance

In Medicaid, the company's flagship business, representing 75% of total premium revenue, the MCR was 92%, and the adjusted pretax margin was 2.6%. The Medicaid performance did not meet expectations, but many would characterize these results as best-in-class in this environment. In Medicare, the MCR was 93.6%, with higher utilization in this high-acuity population, particularly related to long-term services and supports and high-cost drugs. The Marketplace MCR was 95.6%, significantly higher than expected, with elevated utilization relative to risk adjustment revenue.

Guidance Revision

Molina Healthcare revised its full-year 2025 guidance to approximately $14 per share, with a consolidated MCR of 91.3% and a pretax margin of 2.1%. The company expects a full-year MCR of 91.5% in Medicaid, producing a pretax margin of 3.2%. The guidance revision was driven by the challenging medical cost environment and higher utilization in Medicare and Marketplace.

Valuation and Outlook

With a P/E Ratio of 9.91 and an EV/EBITDA of 5.57, the market seems to be pricing in a challenging environment for Molina Healthcare. The company's ROE stands at 20.07%, indicating a relatively strong return on equity. Looking ahead, Molina Healthcare expects growth in its current footprint, significant new Medicaid contracts, and Medicare duals growth. The company's 2026 premium revenue outlook anticipates growth, with a potential revenue increase of 4.7% as per analyst estimates. However, the company's pricing strategy for Marketplace may be a revenue headwind, although earnings accretive.

Growth Initiatives

Molina Healthcare continues to fuel its growth engines, with an active pipeline of $54 billion of new opportunities over the next few years. The company remains opportunistic in deploying capital to accretive acquisitions, with a growing number of actionable opportunities in its acquisition pipeline. The company's embedded earnings, which are earnings on top of current guidance, are $8.65, with a potential third emerging in 2026.

3. NewsRoom

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Molina Healthcare Draws a Major Bet From Cobalt Capital After a Sharp Pullback

Dec -03

Source: fool.com

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Bear of the Day: Molina Healthcare (MOH)

Dec -03

Source: zacks.com

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MOH DEADLINE TODAY: ROSEN, LEADING INVESTOR COUNSEL, Encourages Molina Healthcare, Inc. Investors to Secure Counsel Before Important December 2 Deadline in Securities Class Action - MOH

Dec -03

Source: newsfilecorp.com

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MOH Deadline Today: MOH Investors Have Opportunity to Lead Molina Healthcare, Inc. Securities Fraud Lawsuit

Dec -02

Source: prnewswire.com

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DEADLINE ALERT for MOH, MRX, ATYR, and WPP: The Law Offices of Frank R. Cruz Reminds Investors of Class Actions on Behalf of Shareholders

Dec -02

Source: globenewswire.com

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CPTN INVESTOR ALERT: Bronstein, Gewirtz & Grossman LLC Announces that Cepton, Inc. Investors with Substantial Losses Have Opportunity to Lead Class Action Lawsuit

Dec -02

Source: feeds.newsfilecorp.com

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DEADLINE ALERT for MOH, MRX, WPP: Law Offices of Howard G. Smith Reminds Shareholders of Opportunity to Lead Securities Fraud Class Actions

Dec -02

Source: globenewswire.com

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MOH INVESTOR ALERT: Bronstein, Gewirtz & Grossman LLC Announces that Molina Healthcare, Inc. Investors with Substantial Losses Have Opportunity to Lead Class Action Lawsuit

Dec -02

Source: globenewswire.com

4. Business Breakdown

4.a. Revenues by Country

4.b. Revenues by Segment

5. Expected revenues mid-term growth (3.79%)

6. Segments

Medicaid

Expected Growth: 3.8%

Molina Healthcare's Medicaid segment growth of 3.8% is driven by increasing Medicaid enrollment, expansion into new states, and a growing presence in existing markets. Additionally, the company's focus on providing cost-effective healthcare services and its ability to navigate regulatory changes have contributed to its growth.

Medicare

Expected Growth: 3.5%

Molina Healthcare's Medicare segment growth of 3.5% is driven by increasing enrollment in Medicare Advantage plans, expansion into new markets, and improved health outcomes through value-based care models. Additionally, the company's focus on serving low-income and vulnerable populations, as well as its investments in digital health technologies, contribute to its growth momentum.

Marketplace

Expected Growth: 4.2%

Molina Healthcare's Marketplace segment growth of 4.2% is driven by increasing enrollment in Affordable Care Act (ACA) plans, expansion into new markets, and strategic partnerships. Additionally, the company's focus on providing cost-effective healthcare solutions and improving operational efficiencies have contributed to its growth.

Other

Expected Growth: 3.2%

Molina Healthcare's 3.2% growth in 'Other' segment is driven by increasing demand for Medicaid and Medicare services, expansion into new markets, and strategic acquisitions. Additionally, the company's focus on cost containment and operational efficiencies has contributed to improved profitability.

7. Detailed Products

Medicaid Health Plans

Molina Healthcare offers Medicaid health plans that provide comprehensive healthcare services to low-income individuals and families.

Medicare Health Plans

Molina Healthcare offers Medicare health plans that provide healthcare services to seniors and individuals with disabilities.

Marketplace Health Plans

Molina Healthcare offers Marketplace health plans that provide affordable healthcare coverage to individuals and families.

Dual Eligible Special Needs Plans

Molina Healthcare offers Dual Eligible Special Needs Plans that provide comprehensive healthcare services to individuals who are eligible for both Medicaid and Medicare.

Long-Term Services and Supports

Molina Healthcare offers Long-Term Services and Supports that provide assistance with daily living activities to individuals with disabilities or chronic conditions.

8. Molina Healthcare, Inc.'s Porter Forces

Forces Ranking

Threat Of Substitutes

Molina Healthcare, Inc. operates in a highly regulated industry, which limits the threat of substitutes. However, the increasing adoption of telemedicine and digital health platforms poses a moderate threat to the company's services.

Bargaining Power Of Customers

Molina Healthcare, Inc. serves a diverse customer base, including government-sponsored programs, which reduces the bargaining power of individual customers. Additionally, the company's scale and market presence limit the negotiating power of customers.

Bargaining Power Of Suppliers

Molina Healthcare, Inc. relies on a network of healthcare providers, which gives them some bargaining power. However, the company's scale and market presence mitigate this power to some extent.

Threat Of New Entrants

The healthcare industry is heavily regulated, and new entrants face significant barriers to entry, including high capital requirements and complex regulatory hurdles. This limits the threat of new entrants to Molina Healthcare, Inc.

Intensity Of Rivalry

The healthcare industry is highly competitive, with multiple players vying for market share. Molina Healthcare, Inc. faces intense competition from established players, which increases the intensity of rivalry.

9. SWOT Analysis

Strength

Weaknesses

Opportunities

Threats

10. Capital Structure

10.a. Balance Sheet

10.b. Weighted Average Cost of capital

Value
Debt Weight 36.33%
Debt Cost 6.13%
Equity Weight 63.67%
Equity Cost 6.66%
WACC 6.47%
Leverage 57.06%

11. Quality Control: Molina Healthcare, Inc. passed 5 out of 9 key points

12.a Historical Valuation

12.b Price/Earnings Ratio

12.c Margin Valuation

12.d Peers Valuation

Peers Group Analysis

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Neurocrine Biosciences

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Growth: 9.3

Quality: 8.3

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Momentum: 8.0

Volatility: 7.0

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United Therapeutics

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Value: 3.8

Growth: 8.6

Quality: 8.2

Yield: 0.0

Momentum: 8.5

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Value: 8.9

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Elevance Health

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Value: 6.6

Growth: 5.7

Quality: 6.8

Yield: 3.0

Momentum: 0.5

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Quality: 4.4

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Molina Healthcare

A-Score: 3.9/10

Value: 8.0

Growth: 6.3

Quality: 5.7

Yield: 0.0

Momentum: 0.0

Volatility: 3.7

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Peers Metrics

12.e Scoring Insights

12.f DCF BETA

Parameters

Short Term Growth

Short term Time

Long-Term Growth

WACC

Target Price

151.05$

Current Price

151.05$

Potential

-0.00%

Expected Cash-Flows