Molina Healthcare

What Molina Healthcare does

Molina Healthcare is a FORTUNE 500 managed care organization founded in 1980 and headquartered in Long Beach, California, that provides government-sponsored health insurance to approximately 5.0 million members as of March 31, 2026. The company operates three core product lines: Medicaid managed care (serving low-income individuals and families through state contracts), Medicare Advantage and Dual-Eligible Special Needs Plans, and Marketplace/ACA exchange plans. Membership as of Q1 2026 was 4.498 million Medicaid, 229,000 Medicare, 305,000 Marketplace, and 2,000 Other across 16+ states including California, Florida, Illinois, Texas, Michigan, Nevada, Iowa, and others. State-specific health plan subsidiaries such as Molina Healthcare of Illinois, Florida, Michigan, Nevada, Texas, and Iowa handle contract execution with state Medicaid agencies and CMS.

The company generates revenue through capitated premium payments from state Medicaid agencies, CMS for Medicare programs, and risk-adjustment transfers from state-based ACA exchanges. Operating model is B2G/B2B2C sales-led, with health plans won through state-level competitive RFP processes; Molina reports a 90% RFP renewal win rate on $14 billion in retained revenue. Underlying technology consists of managed care healthcare information systems for claims administration, care coordination, and utilization management — no proprietary AI/ML platforms or differentiated technology stack is disclosed. Strategic posture emphasizes Medicaid scale (90%+ of revenue) with selective Medicare focus on dual-eligibles following the announced 2027 exit from Medicare Advantage Prescription Drug Plans through the ConnectiCare subsidiary. Recent inorganic activity includes ConnectiCare ($350M, 2024), My Choice Wisconsin ($150M, 2022), Affinity Health Plan ($380M, 2020), and Magellan Complete Care ($820M, 2020). Leadership is anchored by CEO Joseph M. Zubretsky (since 2017), with a board recently augmented by managed care veterans including Francis S. Soistman (2026) and Leo P. Grohowski (2025). The company is also subject to active regulatory scrutiny, including an Arizona Attorney General price-fixing lawsuit alleging MultiPlan algorithm-driven under-reimbursements.

Name

Molina Healthcare

Legal name

Molina Healthcare, Inc.

Website

https://investors.molinahealthcare.com

Company type

Public

Founded year

1980

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Molina Healthcare is a public FORTUNE 500 managed care organization providing government-sponsored Medicaid, Medicare, and Marketplace health insurance to approximately 5 million members across 16+ U.S. states through state-contracted health plan subsidiaries.

Ownership category

akta.pro rank

Product category

Managed Care Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro primary industry

Medicaid Managed Care HMOs (HLAEAMAI)

akta.pro secondary industries

Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO), Individual Health Insurance Administration (TPA/ASO) (FSAIAEAK)

Keywords

• Medicaid managed care
• Medicare Advantage plans
• Government-sponsored health insurance
• Health plan services
• ACA marketplace coverage

Headquarters

HQ city

Long Beach

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Operations, Personnel, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Premium Revenue - Medicaid: The company generates revenue through premium payments from state Medicaid programs for managed care services to low-income individuals and families.
2. Premium Revenue - Medicare: Revenue from Medicare programs including Medicare Advantage and dual eligible special needs plans for seniors and disabled individuals.
3. Premium Revenue - Marketplace: Revenue from qualified health plans offered through state insurance marketplaces under the Affordable Care Act.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels5 records

Core offering

Molina Healthcare, Inc. is a FORTUNE 500 managed care company that delivers government-sponsored health insurance plans, primarily Medicaid Managed Care, Medicare Advantage and dual-eligible plans, and qualified health plans on ACA state marketplaces. The company operates through state-specific health plan subsidiaries that contract with state Medicaid agencies, the Centers for Medicare & Medicaid Services (CMS), and state insurance exchanges, serving approximately 5 million members across more than 16 U.S. states.

Product overview

Molina Healthcare operates as a managed care organization offering a portfolio of government-sponsored health insurance products. The core offerings consist of Medicaid Managed Care plans (serving low-income individuals and families under state Medicaid programs), Medicare Plans (including Medicare Advantage and dual eligible special needs plans), and Marketplace/ACA exchange plans. The company delivers these through state-specific health plan subsidiaries, with notable contracts including the HealthChoice Illinois Medicaid Managed Care program and Florida CMS Kids contract. Molina is undergoing strategic shifts, including exiting the Medicare Advantage Prescription Drug (MAPD) product line for 2027 to focus exclusively on dual eligible members, while expanding its Medicaid footprint through new state contract wins.

Differentiator

Problem solved

Functional benefit

Brands

• MolinaCares Accord: Molina Healthcare's charitable initiative focused on community health and wellness programs
• HealthChoice Illinois

Products and services

• Medicaid Managed Care
• Medicare Advantage Plans
• Marketplace (ACA) Plans
• HealthChoice Illinois Medicaid Managed Care Program Illinois Medicaid Managed Care program administered by Molina Healthcare of Illinois as one of six contracted health plans, covering approximately 3.1 million Medicaid beneficiaries statewide under contract with the Illinois Department of Healthcare and Family Services.
• Florida CMS Kids Contract Florida Medicaid contract for children's healthcare services operated by Molina Healthcare of Florida under the Centers for Medicare & Medicaid Services program, carrying approximately $6 billion in revenue at full run rate.
• ConnectiCare Medicare Advantage Plans Connecticut-based subsidiary of Molina Healthcare offering Medicare Advantage plans including Medicare Advantage Part D prescription drug plans, acquired in 2024. The company notified brokers of plans to exit Medicare Advantage Part D prescription drug plans for the 2027 plan year, affecting approximately 48,000 seniors.

Quantifiable outcome

• Illinois Medicaid contract covering approximately 3.1 million beneficiaries as one of six health plans
• +2 more outcomes

Named customers11 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Four partnerships are on record, tiered minor.

• Inland Empire Health Plan (IEHP)minorStrategic or Co-development Partner · 25 June 2026Molina Healthcare collaborated with Inland Empire Health Plan, contributing $1.69 million in funding for the Kern Street Adult Residential Facility in Muscoy, San Bernardino County. The facility provides 30 beds for seriously mentally ill adults with 24-hour supervision, psychiatric care, counseling, and vocational training.
• YoloCaresminorStrategic or Co-development Partner · 11 March 2026YoloCares, a Davis-based nonprofit hospice and palliative care provider, partnered with Molina Healthcare through California's CalAIM initiative to offer community support services at Joshua's House (facility for unhoused patients) and Galileo Place (short-term respite care).
• Partnership HealthPlan of CaliforniaminorStrategic or Co-development Partner · 11 March 2026Partnership HealthPlan of California partnered with YoloCares through CalAIM with support from Molina Healthcare to expand community support services across Yolo, Sacramento, Sutter, Placer, and Colusa counties.
• MaeminorStrategic or Co-development Partner · 6 February 2026Molina Healthcare of Illinois partnered with Mae, a digital maternal health platform, to provide enhanced pregnancy and postpartum support services to Medicaid members across Illinois. The program offers real-time digital symptom monitoring, access to insurance-eligible doulas, and group-based education.

Scale indicators9 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Humana: Medicare Advantage market leader with growing Medicaid presence; directly overlaps with Molina in D-SNP and co-bidding for state Medicaid contracts.
• UnitedHealth Group (UnitedHealthcare): Largest U.S. health insurer with a sizable Medicaid (Community & State) and Medicare Advantage footprint that competes head-to-head against Molina in many state procurements, though its scale spans commercial, PBM, and Optum services.
• Elevance Health (Anthem): Major multi-state Blues-affiliated carrier operating government business (Medicaid, Medicare Advantage, ACA) plans that compete against Molina in numerous state Medicaid contracts.
• CVS Health (Aetna): Aetna's Government Services segment is a significant Medicaid competitor and former employer of multiple Molina board members; comparable across Medicaid managed care and D-SNP.

Direct peers

• Centene Corporation: Largest U.S. pure-play Medicaid managed care company with substantial Marketplace and Medicare exposure; the closest direct comp to Molina given overlapping government-program focus and similar scale by membership.
• HealthCare Service Corporation (HCSC): Large customer-owned Blue Cross Blue Shield licensee with substantial Medicaid managed care presence in multiple states directly competing with Molina on state RFPs.
• Amerigroup (Elevance subsidiary): Elevance's dedicated government programs brand historically focused on Medicaid managed care; directly competes with Molina in several state Medicaid markets.
• CareSource: Non-profit Medicaid managed care organization operating in multiple Midwestern and Mid-Atlantic states; directly comparable to Molina's Medicaid-focused model.

Emerging players

• Highmark Health: Integrated payer-provider with growing Medicaid and Medicare government business; competes with Molina in select state Medicaid programs.

Regional players

• Inland Empire Health Plan (IEHP): California-focused public-sector Medicaid managed care plan that has partnered with Molina on community health initiatives; a regional government-program peer.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks7 records

Key highlights7 records

Customer concentration

• Xx.com/molinahealth
• YouTubeyoutube.com/user/MolinaHealthcare
• Facebookfacebook.com/MolinaHealth
• LinkedInlinkedin.com/company/molina-healthcare
• Instagraminstagram.com/molinahealth

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Subsidiaries9 records

Funding overview

Funding rounds4 records

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A16 records

Investments8 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Molina Healthcare