Competitors

Competitors describe Molina Healthcare, Inc.'s market in their own filings and calls. These verified passages and visual pages show where their strategies meet, using source documents preserved in Sources.

Centene (CNC)

Centene is Molina's single most direct competitor: by its own account the nation's largest Medicaid and Marketplace insurer, bidding for the same state Medicaid contracts, ACA exchange members and dual-eligible (D-SNP) populations that anchor Molina's book.

Centene's stated positioning as the nation's largest Medicaid and Marketplace insurer and largest stand-alone PDP provider — 27.6 million members, $194.8B revenue, and a high D-SNP concentration — spanning all three of Molina's government markets.

During 2025, we operated in four segments: Medicaid, Medicare, Commercial and Other. For the year ended December 31, 2025, our Medicaid, Commercial, Medicare and Other segments accounted for 57%, 21%, 19% and 3%, respectively, of our total external revenues. Our membership totaled 27.6 million as of December 31, 2025. For the year ended December 31, 2025, our total revenues were $194.8 billion and our total cash flow from operations was $5.1 billion. Based on the most recent publicly available membership data, we are the nation's largest Medicaid and Marketplace insurer, as well as the largest stand-alone PDP provider. Our Medicare Advantage business includes one of the highest concentrations of D-SNP members among our peers, aligned with our focus on low-income, complex populations.

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Centene describes refining its Medicare footprint to overlap its Medicaid presence for D-SNP alignment, ahead of CMS rules requiring integrated dual-eligible care from 2027–2030 — the same Medicaid-to-Duals convergence Molina is pursuing.

Accordingly, we have been refining our Medicare footprint to overlap more closely with our Medicaid presence to provide D-SNP offerings that support alignment and have one of the highest D-SNP concentrations among our peers. CMS regulations will require beneficiaries dually enrolled in Medicare and in a Medicaid managed care plan to receive integrated care through the Medicaid company's Medicare Advantage D-SNPs beginning in 2030, with certain restrictions beginning in 2027.

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Centene's CEO on Medicaid competitive dynamics: rate pressure squeezing smaller, nonprofit plans, which it frames as a potential membership-growth opportunity if competitors exit certain geographies.

Sarah London, CEO: Relative to competitive dynamics, we are seeing continued rate pressure having an impact on different markets and certainly some of the smaller, nonprofit plans. And, frankly, this has been an important input into states thinking about making sure that they're funding the programs to be sufficient so that they have a competitive marketplace and that members have the quality of services that they want and they deserve. And I think over time, you know, it's something that we would watch relative to potential membership growth, if competitors choose to exit any of those geographies.

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Elevance Health (ELV)

Elevance is a large government-programs rival across Medicaid, Duals and the ACA marketplace. Its management speaks in unusual detail about the same forces driving Molina — Medicaid rate-versus-acuity lag, redetermination-driven morbidity, and the Medicaid-to-Duals convergence. Featured material is limited to its government business, not its commercial or Carelon-services lines.

Elevance's government-benefits head describes its framework for weighing rate adequacy against trend when deciding whether to exit a Medicaid state contract, and the RFP and annual contract-renewal mechanics involved — the same procurement battlefield Molina bids in.

Felicia Norwood, President, Government Health Benefits: if a state isn't going to deliver the expectations that we need from a financial perspective, we will certainly consider exiting that business if we can't deliver on the long term. But our framework has to consider a lot of variables. We have to take a look at the rate adequacy versus the trend that we're seeing, the program designs, the regulatory environment and policy stability that we see there, all kinds of things with respect to our risk-sharing arrangements, operational challenges and other things. […] if we were to exit, Lance, we would align that with normal changes in terms of contract extensions, which, as you know, actually happen every year because Medicaid contracts, while they are 4 or 5-year contracts, the contract renews every single year. And then there's also certainly the opportunity around RFPs in that strategy with respect to exiting.

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Elevance's CFO attributes roughly 70% of its elevated ACA cost trend to higher-acuity members moving from Medicaid to the ACA exchange during redetermination — the Medicaid-to-Marketplace migration Molina straddles on both sides.

Mark Kaye, CFO: First, the risk pool's acuity and morbidity have significantly increased due to a higher ratio of healthier members, particularly in states with a larger number of fully subsidized individuals. This change has been driven by market exits and the movement of higher acuity members from Medicaid to ACA during the redetermination process, which accounts for approximately 70% of the total impact.

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Elevance describes Duals as a long-standing strategy aligned to its Medicaid footprint and complex-care management — the same convergence of Medicaid and dual-eligible members that is central to Molina's growth.

Felicia Norwood, President, Government Health Benefits: Duals has been a strategy for us for some time. It aligns very well with our Medicaid footprint and also the ability of Carelon to help manage individuals who have complex conditions. So we invested in HMO and duals in order to make sure that we were continuing to focus on those areas that we believe drive great value for seniors and meaningful value for the enterprise.

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UnitedHealth Group (UNH)

UnitedHealth is the largest US health insurer; its UnitedHealthcare Community & State segment is a top-scale Medicaid competitor (32 states, ~7.4M members), and it overlaps Molina in Duals/D-SNP and the ACA exchange. Featured material is limited to the government-programs business, not Optum or commercial.

UnitedHealth's Medicaid (Community & State) footprint — 32 states and DC, nearly 7.4 million members, 1.2 million via ACA expansion — and its description of how states award managed-care plans through a formal bid process.

As of December 31, 2025, UnitedHealthcare Community & State participated in programs in 32 states and the District of Columbia, and served nearly 7.4 million people; including 1.2 million people through Medicaid expansion programs in 19 states under the Patient Protection and Affordable Care Act (ACA). States using managed care services for Medicaid beneficiaries select health plans by using a formal bid process or by awarding individual contracts.

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UnitedHealth's insurance-unit CEO on Medicaid funding lagging member acuity into 2026, with 2026 draft rates received on nearly half of its January-cycle contracts — the rate-adequacy dynamic at the center of Molina's Medicaid margin story.

Tim Noel, CEO of UnitedHealthcare: In Medicaid, the path to recovery will be more challenging. States have not funded in line with actual cost trends. So funding levels are not sufficient to cover the health needs of state enrollees. While we're making steady progress in bridging this gap with states, the mismatch between rate adequacy and member acuity will likely extend through 2026. To date, we have received 2026 draft rates on almost half of our contracts, which have a January 1 rate cycle, and we continue to advocate for rate updates to better reflect our ongoing experience with elevated trends.

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UnitedHealth's stated plan to approach the ACA individual exchange far more conservatively for 2026 — potentially exiting select markets — as subsidy expiration is expected to cut membership and raise morbidity, the same policy cliff facing Molina's Marketplace book.

Tim Noel, CEO of UnitedHealthcare: The individual exchange business, while we are prepared to continue to participate, the majority of the thirty markets we currently serve. We will approach them far more conservatively for 2026. We may need to make the difficult decision to exit select markets if we are unable to achieve the rates necessary for higher market-wide morbidity. Additionally, due to the projected expiration of premium subsidies across the ACA market, our membership should decline significantly. And we are mindful of the potential for adverse selection dynamics as we reprice these offerings for next year.

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CVS Health (Aetna) (CVS)

CVS Health's Aetna competes with Molina in Medicaid, Duals and — until its 2026 exit — the ACA individual exchange. Its decision to leave the exchange, which Molina is expanding into, and its Medicaid rate commentary sit directly on Molina's turf. Featured material excludes CVS's pharmacy/retail and Caremark businesses.

Aetna's government-medical footprint as described in CVS's 10-K: Medicaid/CHIP services in 15 states and a fully coordinated dual-eligible (Duals) offering — the Medicaid and Duals lines that overlap Molina.

Medicaid and CHIP: The Company offers health care management services to individuals eligible for Medicaid and CHIP under multi-year contracts with government agencies in various states that are subject to annual appropriations. CHIP are state-subsidized insurance programs that provide benefits for families with uninsured children. The Company offered these services on an Insured or ASC basis in 15 states in 2025. Duals: The Company provides health coverage to beneficiaries who are dually eligible for both Medicare and Medicaid coverage. These members must meet certain income and resource requirements in order to qualify for this coverage. The Company coordinates 100% of the care for these members and may provide them with additional services in order to manage their health care costs.

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Aetna's benefits president on Medicaid rate advocacy and a high-trend 2026 environment, saying it remains cautious while working with states on adequate rates — the same rate-versus-trend balance Molina manages.

Steve Nelson, President, Health Care Benefits (Aetna): Look, the Medicaid business has been performing in line with our expectations. We had a really strong year of rate advocacy execution in 2025, and we're going to continue that focus and discipline there. As we enter 2026, again, I think we're off to a strong execution start. It's obviously a high trend environment. We remain cautious and prudent as we think about this, but the trends that we're seeing are in line with what we've laid out in our expectations. We're going to continue to work really closely with our state partners to make sure we have adequate rates while also providing clinical and operational excellence.

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CVS frames its exit from the ACA individual exchange as a 2026 tailwind — the opposite of Molina's Marketplace expansion — while taking a cautious Medicaid outlook amid industry-wide pressure.

Brian Newman, CFO: With our Health Care Benefits business, we expect another year of meaningful margin improvement at Aetna. This includes another year of progress in our Medicare Advantage business, supported by our disciplined approach to plan design and footprint in individual as well as repricing opportunities in our group business. We also expect a tailwind from our exit of the individual exchange business. Although our conversations with our Medicaid state partners continue to progress and this business has performed in line with our expectations this year, we are taking a cautious outlook in light of the broader pressures across the industry.

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Humana (HUM)

Humana is Medicare-Advantage-centric but is expanding state Medicaid contracts specifically to build integrated dual-eligible (D-SNP) plans — the highest-overlap segment with Molina's Duals franchise — making its Medicaid-procurement strategy a direct competitive read-across.

Humana's insurance-segment head says it views its Medicaid business 'through the lens of duals,' claiming a leading Medicaid-procurement success rate by targeting areas with strong dual-eligible overlap — the same integrated-Duals prize Molina pursues.

George Renaudin, President, Insurance Segment: Regarding the dual opportunity, we view our Medicaid business through the lens of duals, particularly as we consider the changes planned for dual integration states. We have seen a leading success rate in Medicaid procurements by focusing on areas with strong connections to the dual opportunity. The rationale for this is that duals generally provide higher margins compared to traditional or Medicare Advantage businesses. We have observed that these dual products perform well financially right from the first year, in contrast to some core products that take longer to yield benefits. We're actively experiencing this trend and have secured several Medicaid contracts, which will enhance our dual market presence in key areas.

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Humana's CEO on its Medicaid expansion to 10 states (plus three awarded), noting its book skews to non-expansion states and LTSS populations that it expects to be less exposed to federal Medicaid cuts than Medicaid broadly.

Jim Rechtin, President and CEO: Strategic expansion of Medicaid continues with the launch of the Virginia contract, this brings our active footprint to 10 states with 3 more states awarded in pending. I know there's been a lot of curiosity about the impact of the Big Beautiful Bill. Our footprint in Medicaid is largely in non-expansion states, and it tends to be skewed towards the LTSS or long-term support services population. These geographies in this population are less impacted by the bill. So while the bill will certainly have some impact, we expect it to be more muted for us versus Medicaid broadly. We remain committed to our Medicaid strategy and the assumptions we made at Investor Day about margin progression.

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Humana distinguishes its own Medicaid book from a competitor's troubled Florida exposure, pointing to differences in product mix, state footprint and value-based network structure.

George Renaudin, President, Insurance Segment: I think that one of our competitors did acknowledge that their Florida problem was really specific to a population that we don't have exposure to. So again, you have to think about product first, you have to think about the state footprints. And then the third part that is really important to think about with Medicaid is the network structure.

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Competitors

Centene (CNC)

Elevance Health (ELV)

UnitedHealth Group (UNH)

CVS Health (Aetna) (CVS)

Humana (HUM)

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