Molina Healthcare pulling out of two states, raising premiums 55% in remaining states

Molina Healthcare announced today that the company will be pulling out of Obamacare exchanges in Utah and Wisconsin and reducing its participation in the Washington market. The company is still considering its continued participation in other states. In those states where it does remain, Molina will be requesting a 55% increase in premiums for 2018. From the company’s press release:

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  1. We are exiting the Utah and Wisconsin ACA Marketplaces effective December 31, 2017. For the three months ended June 30, 2017, these two health plans reported a total of $127 million in Marketplace premium revenue (16% of consolidated Marketplace premium revenue), and a combined Marketplace medical care ratio of 128%.
  2. In our remaining Marketplace plans, we are increasing 2018 premiums by 55%. The increase takes into account the absence of cost sharing reduction subsidies. Had we assumed that cost sharing reduction subsidies would be funded for 2018, the premium increase would have been 30%.
  3. We are also reducing the scope of our 2018 participation in the Washington Marketplace.
  4. We continue to closely monitor the current political and programmatic developments pertaining to our 2018 participation in other Marketplace states, and subject to those developments, will withdraw from 2018 participation as may be necessary.

All of this comes as Molina announced a net loss of $230 million for the second quarter. Monday the company announced plans to lay off about 10% of it’s workforce. From Modern Healthcare:

Medicaid health plan Molina Healthcare intends to lay off 1,400 employees, or 10% of its workforce, over the coming months to try to offset losses from its Obamacare exchange business, the company said in an internal memo to employees Monday…

“As part of our drive for operational efficiencies, we are simplifying our organizational structure and reducing the size of our workforce. This was a very difficult decision, and one that I do not take lightly,” White said.

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Molina fired its CEO and CFO, the sons of the company’s founder, in May. Molina was considered one of the big successes in the Obamacare market as recently as last September. From the Hill:

Molina’s plans are now among the most affordable on the market. But unlike other companies that tried to attract customers in the first year of ObamaCare with ultra-cheap plans, Molina is staying profitable…

The big insurers’ troubles have led critics to raise questions about the overall sustainability of the ObamaCare model.

But Molina sees more room for his company to grow. It has already announced plans to expand this year into three more markets.

It was all going so well for Molina until it wasn’t. Now the low-cost provider is cutting staff, pulling out of at least two states and jacking up premiums by 55% in the remainder. Even without the possibility of cost-sharing reduction payments being cut off by the Trump administration, Molina would still be requesting a 30% increase in premiums. There’s no way to spin that as a success story.

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David Strom 6:00 AM | April 25, 2024
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