Competition

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 Corporation (CNC)

Centene is Molina's closest pure-play peer — the largest Medicaid and ACA Marketplace insurer in the country, competing directly for the same state contracts, exchange members and dual-eligible populations.

Centene's 10-K claims the number-one position in Medicaid and Marketplace and one of the highest D-SNP concentrations among peers — the three government programs that make up Molina's entire book.

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 sizes the Medicaid market (CMS: 7% annual growth to $1.5 trillion by 2031) and states its own Medicaid scale — 12.5 million members across 30 states.

CMS estimates Medicaid spending will grow at an average annual rate of 7% to $1.5 trillion by 2031. […] We are the largest Medicaid health insurer in the country, serving 12.5 million Medicaid members in 30 states as of December 31, 2025.

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Centene's stated Marketplace scale — 5.5 million ACA exchange members in 29 states under its Ambetter brand — the same subsidized-individual market where Molina competes.

We are the largest Marketplace carrier, serving 5.5 million members across 29 states as of December 31, 2025, under the brand name Ambetter Health.

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Elevance Health, Inc. (ELV)

Elevance is one of the largest Medicaid managed-care operators and a major ACA carrier; its earnings calls detail the Medicaid rate/acuity squeeze and Medicaid-to-exchange migration that also drive Molina's results.

Elevance's CFO says state Medicaid rates continue to lag member acuity, pushing its 2025 Medicaid margin modestly negative with a further decline of at least 125 bps expected in 2026 — the rate-adequacy squeeze common to Medicaid MCOs.

Mark Kaye (CFO): Medicaid performance reflected pressure from elevated acuity and utilization, which were not fully offset by rate updates. We now expect our full year 2025 Medicaid operating margin to be modestly negative, establishing a baseline from which we anticipate a decline of at least 125 basis points in 2026 as rates continue to lag acuity and utilization trends remain elevated.

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Elevance's CFO attributes roughly 70% of its rising ACA medical-cost trend to higher-acuity members moving from Medicaid into the exchanges during redeterminations — a market-migration dynamic that runs across Molina's Medicaid and Marketplace lines.

Mark Bradley Kaye (CFO): There are three main factors we are observing that contribute to the significant increase in medical trends in our ACA business. 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 ties its 2026 Medicaid membership outlook to redetermination normalization, state program changes and RFP outcomes — naming competitive state contract results as a swing factor in the shared Medicaid market.

Mark Kaye (CFO): our Medicaid membership outlook, while very preliminary at this point, does consider things like the continued normalization following the redetermination process as well as the impact of state program changes and RFP outcomes. Whilst we do expect some churn to persist into next year, we do expect the pace of disenrollment to be manageable, and we are beginning to see stabilization in some of our markets.

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UnitedHealth Group Incorporated (UNH)

UnitedHealth's Community & State unit is among the largest Medicaid managed-care businesses; through it and its D-SNP/duals franchise, UNH bids against Molina for state Medicaid contracts.

UnitedHealth sizes its Medicaid franchise (UnitedHealthcare Community & State) at more than 7.4 million people across 33 states and DC, including 1.2 million in ACA Medicaid expansion — the scale a state-focused rival like Molina competes against.

UnitedHealthcare Community & State’s primary customers oversee Medicaid plans, including Temporary Assistance to Needy Families; Children’s Health Insurance Programs (CHIP); Dual SNPs (DSNPs); Long-Term Services and Supports (LTSS); Aged, Blind and Disabled; and other federal, state and community health care programs. As of December 31, 2024, UnitedHealthcare Community & State participated in programs in 33 states and the District of Columbia, and served more than 7.4 million people; including 1.2 million people through Medicaid expansion programs in 20 states under the Patient Protection and Affordable Care Act (ACA).

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UnitedHealth's UnitedHealthcare president cites state-rate pressure, expected Medicaid membership attrition and negative 2026 margins pending state rate alignment — the same Medicaid funding backdrop Molina navigates.

Timothy Noel (President, UnitedHealthcare): Community & State results continue to reflect pressures in state-based rate environments, but were within the overall expected range. […] In Medicaid, we remain focused on improvements in high acuity care management and operating cost management. […] We continue to expect membership attrition and negative margins in 2026 in light of continuing high trend and insufficient funding with modest margin improvements beginning in 2027. […] Appropriately aligning state rates to elevated medical cost trends in these programs is essential to sustainably serving people who rely on them.

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CVS Health Corporation (CVS)

Through Aetna, CVS competes in Medicaid, Medicare Advantage, D-SNP and duals — though it exited the ACA exchanges in 2026, marking a strategic divergence from Molina's exchange growth.

CVS's CFO frames the individual-exchange exit as a 2026 tailwind and takes a 'cautious outlook' on Medicaid amid industry-wide pressure — Aetna prioritizing margin over the exchange and Medicaid growth Molina pursues.

Brian Newman (Chief Financial Officer): 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 Inc. (HUM)

Humana is Medicare-centric but is expanding its Medicaid footprint (now 13 states, adding Georgia and Texas) and is a large dual-eligible/D-SNP player, overlapping Molina in duals and state Medicaid.

Humana lists its Medicaid state-contract footprint (10 states) and its dual-eligible integration strategy across Medicaid, Medicare Advantage and PDP — the duals and Medicaid ground where the Medicare-centric insurer overlaps Molina.

We have contracts in multiple states to serve Medicaid-eligible members, including Florida, Kentucky, Illinois, Indiana, Louisiana, Ohio, Oklahoma, South Carolina, Virginia and Wisconsin. We also serve members who qualify for both Medicaid and Medicare, referred to as "dual eligible", through our Medicaid, Medicare Advantage, and stand-alone prescription drug plans. As the dual eligible population represents a disproportionate share of costs, Humana is participating in varied integration models designed to improve health outcomes and reduce avoidable costs.

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Humana's CEO says its Medicaid footprint now spans 13 states, with Georgia and Texas launching next year — a direct expansion into large Medicaid markets where Molina operates.

James Rechtin (President and CEO): we continue to grow our Medicaid and CenterWell footprint. Medicaid now spans 13 states. Including Georgia and Texas, which are anticipated to launch next year. We also hope to soon announce a strategic acquisition in the primary care space.

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Humana's Medicaid (state-based) membership grew 10.7% to about 1.6 million as of year-end 2025, driven mainly by its newly implemented Virginia contract — evidence of a peer adding Medicaid share through state wins.

State-based contracts and other membership increased 155,700 members, or 10.7%, from 1,459,900 members as of December 31, 2024 to 1,615,600 members as of December 31, 2025 primarily due to the Virginia contract implemented in 2025 […]

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The Cigna Group (CI)

Cigna is the most distant peer: it has no Medicaid or Medicare risk business and has deliberately shrunk its ACA exchange book, so it collides with Molina only at the individual-exchange edge.

Cigna's president states it has 'no exposure to Medicaid or Medicare,' serving those customers only through its Evernorth (PBM/services) portfolio — the clearest marker of how little Cigna's risk-bearing book overlaps Molina's.

Brian C. Evanko (President and COO): we have intentionally positioned our Cigna Healthcare portfolio with a product mix that has proven favorable in the current environment as we have no exposure to Medicaid or Medicare, instead choosing to serve these customers through our Evernorth services portfolio.

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Cigna's president recounts shrinking its individual-exchange book from ~1 million to under 400,000 members to prioritize margin, noting competitors grew and industry exchange enrollment rose nearly 50% — sizing the ACA market Molina and Centene expanded into.

Brian C. Evanko (President and COO): At that point in time, we served nearly 1 million customers in the individual exchanges, albeit with mixed financial performance. Based upon our performance as well as our forward view of the market, we made the strategic choice to prioritize margin over growth, which included adjustments to product and network strategies, refinements to our geographic footprint, and increased prices where necessary. […] we now serve fewer than 400,000 customers in this business, down materially from the nearly 1 million we served in 2023. […] some of our competitors showed meaningful growth in their individual exchange businesses, while we chose to reposition our portfolio, which resulted in fewer individual exchange customers for Cigna Healthcare. […] Meanwhile, across the industry, individual exchange enrollment is up nearly 50% over that same time period.

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Competition

Centene Corporation (CNC)

Elevance Health, Inc. (ELV)

UnitedHealth Group Incorporated (UNH)

CVS Health Corporation (CVS)

Humana Inc. (HUM)

The Cigna Group (CI)

More peer documents