Molina Healthcare is a pure-play managed care organization focused entirely on government-sponsored health programs. Molina contracts with state and federal governments to manage healthcare for low-income and vulnerable populations under Medicaid, Medicare, and the ACA Marketplace, serving approximately 5.5 million members across 21 states. Medicaid is the core business, representing roughly 75% of premium revenue, covering low-income families, disabled individuals, children, and Medicaid Expansion populations. Molina wins Medicaid business through competitive state RFP processes, typically securing multi-year contracts. The business model is straightforward: Molina collects fixed per-member per-month premiums from governments and profits by spending less on medical costs than it receives. The gap between premiums and medical costs — the Medical Care Ratio — is the primary profitability driver. Molina also operates a Medicare segment focused on dual-eligible populations (low-income individuals who qualify for both Medicaid and Medicare), and a smaller, deliberately limited ACA Marketplace segment targeting heavily subsidized low-income members. Molina grows through three channels: winning new and renewal Medicaid RFPs, acquiring smaller single-state Medicaid plans at attractive prices, and expanding its integrated dual-eligible Medicare products. Near-term headwinds include a Medicaid rate-trend imbalance, pending policy changes from the One Big Beautiful Bill Act that introduce work requirements and more frequent eligibility redeterminations, and a significant planned reduction in Marketplace exposure due to expiring ACA subsidies.