Molina Healthcare will continue to shrink its exchange business, President and CEO Joseph Zubretsky said on a July 23 earnings call.
The insurer plans to focus on its marketplace membership in roughly six states versus the 13 or 14 the company currently operates in.
In 2026, Molina put forward average rate increases of 30% to help reduce the company’s marketplace footprint, Mr. Zubretsky said on the call.
“What we can control is how much capital we’re willing to allocate to the business, where we make it available and what the price levels are,” he said.
Mr. Zubretsky said the company was actively aiming to not be the first- or second-best-priced plan in most markets. Molina anticipates lower membership next year as the company sets prices based on its acuity and risk adjustment, reducing marketplace revenue by $1 billion in 2027, executives said.
As of June 30, marketplace membership was at 283,000, down from 655,000 at the end of 2025 and 690,000 one year ago. Marketplace premium revenue for the quarter dropped to $628 million, compared to $1.2 billion the same time one year prior. According to the earnings report, emerging trends indicate a $1.50 increase in earnings per share in Medicare could be offset by a $1.50 decrease stemming from the marketplace business in 2026.
The marketplace business’ medical cost ratio surpassed expectations and reached 88.9% for the quarter, highlighting a significant acuity shift. The MCR also reflected prior-year risk adjustment and program integrity efforts. Mr. Zubretsky said Molina has faced more adverse selection than others in the market.
“That acuity shift was underestimated in pricing, pure and simple,” Mr. Zubretsky said.
“A member who’s on a $1,000-a-month therapy and is comfortable that a competing product has that in their formulary, and they’re looking at our price — which might be $50, $75 or $100 higher than the competitors — they will move at some point,” Mr. he added
Other insurers, including Cigna and PacificSource, have also shared plans to step back from ACA offerings this year.
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