Molina Healthcare (MOH) Q1 2026 earnings summary

Executive summary

• Q1 2026 premium revenue was $10.2 billion, down 4% year-over-year, with adjusted EPS of $2.35 and GAAP net income of $14 million ($0.27 per share), impacted by a $93 million impairment from the planned Medicare Advantage - Part D exit and lower membership.

• Membership declined 12% year-over-year to approximately 5.0 million, mainly due to Medicaid market contraction, contract expiration in Virginia, and Marketplace strategy shifts.

• Consolidated medical cost ratio (MCR) rose to 91.1% from 89.2% in Q1 2025, reflecting higher medical costs and disciplined cost management.

• Full-year 2026 premium revenue guidance reaffirmed at ~$42 billion and adjusted EPS at least $5, despite higher Medicaid attrition and ongoing market pressures.

• No significant acuity shift expected from further Medicaid declines as low/no utilizers are at historic lows.

Financial highlights

• Q1 premium revenue: $10.2 billion; adjusted EPS: $2.35; GAAP net income: $14 million; adjusted net income: $120 million.

• Q1 consolidated MCR: 91.1%; Medicaid MCR: 92%; Medicare MCR: 89.8%; Marketplace MCR: 84% (adjusted to 79.5% for prior year impacts).

• Adjusted G&A ratio for Q1: 6.9%; reported G&A ratio: 7.2%.

• Operating cash flow: $1.1 billion; parent company cash: $213 million at quarter end.

• Debt at quarter end: 6.1x trailing 12-month EBITDA; debt-to-capital ratio: ~48%.

Outlook and guidance

• Full-year 2026 premium revenue guidance reaffirmed at ~$42 billion; adjusted EPS guidance at least $5; GAAP EPS expected to be at least $1.90.

• Medicaid membership expected to decline 6% to 4.5 million by year-end, with Marketplace membership projected at 250,000 and Medicare at 230,000.

• Full-year consolidated MCR guidance unchanged; Medicaid MCR: 92.9%; Medicare MCR: 94%; Marketplace MCR: 85.5%.

• Earnings seasonality expected to be front-end loaded due to Medicaid rate cycle and Florida CMS contract ramp-up.

• Guidance to be updated after Q2 2026 results.