MCOS- Molina expects contract wins to offset Medicaid losses

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[MM Curator Summary]: Molina assures shareholders it will be just fine during the return to normal operations. So does Centene.


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Illustration: Xavier Lalanne-Tauzia for Industry Dive

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Molina Healthcare executives said new contract wins will mitigate Medicaid member losses as consumer protections that shielded millions from losing coverage during the COVID-19 pandemic come to an end.

The insurer said it expects to lose about 300,000 Medicaid members when states resume eligibility checks beginning this spring, but Molina expects to pick up 200,000 members in Iowa and 40,000 in Wisconsin, which could help offset membership losses from redeterminations.

Molina won its contract bid in Iowa last year to provide Medicaid services in the state and it also acquired MyChoice Wisconsin, an existing Medicaid plan.

Overall, Molina expects 2023 Medicaid membership to be flat year over year, even as millions are poised to lose Medicaid coverage as states start to determine if Medicaid members are still eligible for coverage. 

Molina did not forecast how many Medicaid members it anticipates adding to its subsidized Affordable Care Act plans once members no longer qualify for Medicaid.

Molina CEO Joe Zubretsky said the data used to predict enrollment from redeterminations is “pretty imprecise.”

However, Centene, a Molina competitor, said it expects to recapture 300,000 members from redeterminations for marketplace plans. Centene expects to lose a total of 2.2 million Medicaid members to redeterminations.

States were barred from removing people from Medicaid during the public health emergency but can resume eligibility checks starting April 1, threatening to cut off coverage for millions.

Molina CEO Joe Zubretsky said the company’s success rate on bids for new and existing business was “exceptional.”

“We remain confident in our ability to win additional state contracts,” Zubretsky said during Thursday’s fourth-quarter earnings call with investors.

Zubretsky said Molina received notice at the end of January that it successfully defended its existing territory in Texas and will retain contracts in all of its existing service areas.

Molina reported a $792 million profit for 2022, a 20% jump from the prior-year period as the insurer generated 15% higher premium revenue due to acquisitions and membership growth in Medicaid and Medicare.