Molina Healthcare reported a GAAP loss per diluted share of $3.15 for the fourth quarter of 2025, compared with adjusted loss per diluted share of $2.75. Premium revenue for the quarter rose to $10.7 billion from $10.5 billion a year earlier, driven by rate increases and acquisitions. For the full year, GAAP earnings per diluted share were $8.92, down 56% from the prior year, while adjusted earnings per share totaled $11.03, a 51% decrease. Full-year premium revenue increased 11% to $43.1 billion, reflecting organic growth and new contract wins in key markets such as California and Florida.

The consolidated medical care ratio for 2025 stood at 91.7%, up from 89.1% in 2024, driven by higher utilization in Medicaid (91.8%) and Medicare Advantage (92.4%) populations. The Marketplace segment recorded a 90.6% ratio, pressured by elevated service utilization. General and administrative expenses remained disciplined, with a full-year G&A ratio of 6.6% (6.5% on an adjusted basis). Operating cash flow swung to an outflow of $535 million for 2025, compared with an inflow of $644 million in 2024, largely due to Medicaid risk corridor settlements, timing of tax payments and softer second-half medical cost management.

Molina issued guidance for full-year 2026 premium revenue of approximately $42 billion, a 2% decline, reflecting planned Marketplace reductions offset by growth in a new Florida Medicaid contract. The company expects GAAP earnings per diluted share of at least $3.20 and adjusted earnings of at least $5.00, with a $2.50 per share headwind from implementation of the new Medicaid contract and underperformance in the traditional Medicare Advantage Part D business, which Molina will exit in 2027. Management forecasts a consolidated medical care ratio of 92.6% and a G&A ratio of 6.5%, and projects year-end membership of 5.1 million across Medicaid, Medicare and Marketplace segments.