Molina Healthcare loses $91M in Q4, mulls ACA exchange exit

Long Beach, Calif.-based Molina Healthcare reported a net loss of $91 million in the fourth quarter of 2016, compared to the $30 million profit the payer made during the same period last year. The insurer cited poor performance in its ACA marketplace business as the reason for the loss.

For full-year 2016, the insurer reported net income of $8 million, down from $143 million the year prior.

"While we experienced strong enrollment growth across our business and have made progress on our cost cutting efforts, today's results highlight the continuing challenges we face in the ACA marketplace," said J. Mario Molina, MD, CEO of Molina Healthcare. In an earnings call Wednesday, he added "there are simply too many unknowns with the marketplace program to commit to our participation beyond 2017," according to the Press-Telegram.

Despite the losses, Molina said strong enrollment growth for full-year 2016 generated approximately $16.3 billion in premium revenue, an increase of 23 percent from 2015. The insurer said enrollment growth was primarily due to increased marketplace enrollment and its acquisition of Medicaid managed care membership.

The payer's total revenue for Q4 2016 was $4.5 billion, up from $3.9 billion in the same period last year. For full-year 2016, Molina said its total revenue was $17.7 billion, up from $14.2 billion last year.

However, Molina's risk adjustment payments totaled $325 million for 2016, accounting for 24 percent of total premium in 2016. Molina also said the government owes the insurer $90 million in risk corridor payments for 2016.  

Molina projected adjusted earnings of $2.09 per share for 2017, while analysts forecasted $3.69, on average, according to Thomson Reuters. Molina's shares dropped 14 percent as a result, according to the report.  

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