> ## Content Index > Fetch the complete content index at: https://www.bullished.co/llms.txt > Use this file to discover other available public pages before exploring further. # Molina CEO Sees 'Beginning Of The Turn' In Medicaid Margins, But 2027 Premium Outlook Drops To At Least $45 Billion - URL: https://www.bullished.co/molina-ceo-sees-beginning-of-the-turn-in-medicaid-margins-but-2027-premium-outlook-drops-97a49b67/ - Published: 2026-10-22T13:16:00.000Z - Updated: 2026-10-22T13:16:00.000Z - Description: Georgia and Texas contract delays cut the 2027 premium view from $46.5 billion, while early-2027 earnings building blocks top $9.50 per share. - Author: Matteo Parrino - Tags: Earnings, MOH, Industry: Healthcare [Molina Healthcare](https://www.bullished.co/tag/moh/) CEO Joseph Zubretsky said on the company's third-quarter earnings call that "we believe we are likely observing the beginning of the turn in Medicaid margins," even as the company [cut its 2027 premium revenue view](https://finance.yahoo.com/healthcare/articles/molina-healthcare-reports-third-quarter-201500037.html?ref=bullished.co) to at least $45 billion from $46.5 billion. CFO Mark Keim tied the cut to delays in new Georgia and Texas Medicaid contracts. ## What management said on the call Zubretsky said preliminary 2027 earnings building blocks sum to more than $9.50 per share from known items. They assume no improvement in legacy Medicaid or Medicare medical cost ratios, the share of premiums spent on care. Keim laid out the math. It starts from 2026 guidance of at least [$5.25 per share](https://finance.yahoo.com/healthcare/articles/molina-q3-earnings-snapshot-205315426.html?ref=bullished.co), adds about $4 of known embedded earnings, and adds $0.75 if the Marketplace business reaches at least break-even. California's termination of its UIS program is a slight headwind. Keim said every 100 basis points (one percentage point) of Medicaid medical cost ratio is worth about $5 per share, so any legacy improvement would be upside to the 2027 outlook. For the third quarter, Zubretsky reported adjusted earnings of 89 cents per share on [$10.5 billion](https://www.sec.gov/Archives/edgar/data/1179929/000117992926000042/moh3q26%5Fer.htm?ref=bullished.co) of premium revenue, with a consolidated medical cost ratio of 92.9%. He reaffirmed 2026 adjusted earnings guidance of at least $5.25 per share and premium revenue of about $42 billion. ## Rates, trend and the revenue cut Zubretsky said the January 1 renewal cohort is 55% of full-year premium. Draft rates are known for 80% of it and average about 7%. Combined with carryover rates from late 2026, rates are known on 70% of 2027 premium, and overall 2027 increases may approximate 6%. Medical cost trend for 2027 is projected at 5.5% to 6%, which he said includes 50 basis points of conservatism. Using the top of that range, he said rates should at least capture trend, and legacy Medicaid margin should be at least flat, with potential for improvement. The view will be updated in February. Keim said the premium outlook rests on about $6 billion of known tailwinds against about $3 billion of known headwinds: the exit from Medicare Advantage plans, a smaller Marketplace footprint and California's UIS termination. He said the lower revenue number also shifts about 50 cents of operating-leverage benefit out of the $4 per share expected to be realized in 2027. Zubretsky described 2026 as a trough, with three straight years of trend running ahead of rates. He said Medicaid trend was 6.5%, 7.5% and 5.5% in 2024, 2025 and 2026. ## Work requirements and Florida Management assumes a 6% membership loss in 2027 from Medicaid work requirements and re-verifications. Zubretsky said that has only a half-year effect on revenue, and that about 80% of Molina's states are leaning toward policies that favor enrollment. Keim said Nebraska's state data show 90% of renewing members re-enrolled. The Florida CMS contract started with 115,000 members and a run rate of $6 billion in revenue. Keim expects about a 99% medical cost ratio and a 5% pre-tax loss on it in the fourth quarter, and breakeven or better in 2027. Management said it will update the 2027 view, including whether legacy Medicaid margins improve, in its initial guidance in February. ### Sources - [Molina Healthcare Reports Third Quarter 2026 Financial Results](https://finance.yahoo.com/healthcare/articles/molina-healthcare-reports-third-quarter-201500037.html?ref=bullished.co) — Yahoo Finance - [Molina: Q3 Earnings Snapshot](https://finance.yahoo.com/healthcare/articles/molina-q3-earnings-snapshot-205315426.html?ref=bullished.co) — Associated Press - [Molina (MOH) Surpasses Q3 Earnings and Revenue Estimates](https://finance.yahoo.com/healthcare/articles/molina-moh-surpasses-q3-earnings-225003193.html?ref=bullished.co) — Yahoo Finance - [Molina Healthcare Posts Lower Third-Quarter Profit, Revenue - WSJ](https://www.wsj.com/business/earnings/molina-healthcare-posts-lower-third-quarter-profit-revenue-12588ddc?ref=bullished.co) — The Wall Street Journal - [Document](https://www.sec.gov/Archives/edgar/data/1179929/000117992926000042/moh3q26%5Fer.htm?ref=bullished.co) — sec.gov ### More on Molina Healthcare - [Molina's Third-Quarter Net Income Falls 52% To $38 Million, Yet 2026 Guidance Stands](https://www.bullished.co/molinas-third-quarter-net-income-falls-52-to-38-million-yet-2026-guidance-stands-5474da47/) [All Molina Healthcare (MOH) coverage →](https://www.bullished.co/tag/moh/)