Visible Alpha
Visible Alpha broker models via S&P Xpressfeed · 14 brokers · 316 line items · freshest revision 2026-07-14.
Broker models frame Molina as a 2026 earnings trough followed by a Medicaid-rate-led recovery. Consolidated premium revenue dips to ~$42.1B in FY-2026 before reaccelerating to ~$46.3B (FY-2027) and ~$50.3B (FY-2028) as Medicaid rates catch up to medical cost. The consolidated medical cost ratio peaks near 92.5% in 2026, and adjusted EBITDA nearly halves to ~$702M before rebuilding. Marketplace has been deliberately shrunk to its most profitable core, while Medicaid PMPM does the heavy lifting on the top line.
Margins bottom in 2026: consolidated MCR peaks near 92.5% before easing to ~91.8%
| Line | FY-2025A | FY-2026E | FY-2027E | FY-2028E | YoY | Brokers |
|---|---|---|---|---|---|---|
| Cost ratio % | — | — | — | — | — | — |
| Medical cost ratio(%) | 91.3% | 92.5% | 92.1% | 91.7% | +1.2pt | 13 |
| Medical cost ratio - Medicaid(%) | 91.5% | 92.8% | 92.6% | 92.3% | +1.3pt | 12 |
| Medical cost ratio - Medicare(%) | 91.4% | 93.8% | 92.5% | 91.9% | +2.4pt | 12 |
| Medical cost ratio - Marketplace(%) | 90.0% | 85.6% | 83.9% | 83.2% | -4.4pt | 12 |
| Profit $M | — | — | — | — | — | — |
| Medical margin | $3.71bn | $3.16bn | $3.66bn | $4.09bn | -14.8% | 13 |
| Adjusted EBITDA | $1.23bn | $704.02m | $1.01bn | $1.33bn | -42.5% | 10 |
Key drivers
| Line | FY-2025A | FY-2026E | FY-2027E | FY-2028E | YoY | Brokers |
|---|---|---|---|---|---|---|
| Premium Revenue - Medicaid | $32.00bn | $33.04bn | $38.03bn | $40.49bn | +3.2% | 13 |
| Premium revenue - Medicare | $6.12bn | $6.43bn | $5.64bn | $6.02bn | +5.0% | 13 |
| Premium Revenue - Marketplace | $4.58bn | $2.67bn | $2.61bn | $2.84bn | -41.7% | 13 |
| Premium revenue | $42.78bn | $42.11bn | $46.04bn | $48.91bn | -1.6% | 14 |
Key drivers
Marketplace shows the opposite: membership more than halves while PMPM climbs from ~$549 to ~$939 — a deliberate mix shift toward margin.
| Line | FY-2025A | FY-2026E | FY-2027E | FY-2028E | YoY | Brokers |
|---|---|---|---|---|---|---|
| Members (M) | — | — | — | — | — | — |
| Average Membership - Medicaid(M#) | 4.74m Number | 4.54m Number | 4.65m Number | 4.77m Number | -4.2% | 12 |
| Average Membership - Marketplace(M#) | 563,525 Number | 437,338 Number | 246,985 Number | 250,464 Number | -22.4% | 12 |
| PMPM ($) | — | — | — | — | — | — |
| Per Member Per Month (PMPM) - Medicaid($) | $574.5 | $606.8 | $673.1 | $710.2 | +5.6% | 12 |
| Per Member Per Month (PMPM) - Marketplace($) | $556.6 | $831.3 | $881.0 | $934.6 | +49.4% | 12 |
Brokers split on the 2027 recovery: Medicaid rate and the EBITDA rebound are most contested
| Line | Period | Median | Q1–Q3 | Min–max | Brokers |
|---|---|---|---|---|---|
| Per Member Per Month (PMPM) - Medicaid($) | FY-2027E | $664.8 | $632.2–$694.6 | $604.1–$794.0 | 12 |
| Average Membership - Medicaid(M#) | FY-2027E | 4.57m Number | 4.47m Number–4.75m Number | 4.38m Number–5.35m Number | 12 |
| Premium revenue | FY-2027E | $46.30bn | $45.28bn–$47.86bn | $41.57bn–$49.06bn | 14 |
| Adjusted EBITDA | FY-2027E | $1.05bn | $1.00bn–$1.10bn | $604.84m–$1.18bn | 10 |
Marketplace: shrunk on purpose into the most profitable book
Models show Marketplace membership more than halving from ~556k (FY-2025) to ~248k (FY-2027) while its medical cost ratio falls from ~90% to ~84% and PMPM rises toward ~$885 — margin chosen over volume.
Coverage is solid on the P&L but thins on forward KPIs
Headline revenue and MCR draw on 11-14 brokers, but adjusted EBITDA and segment KPIs thin to 7-10, and the FY-2027 recovery is genuinely unsettled — operating EPS spans ~$3.50 to ~$13.50.
Headline P&L consensus, momentum and beat/miss live in the CapIQ tab.