Quick answer
Molina Healthcare is pulling back sharply from the ACA Marketplace for 2027, shrinking its footprint from 14 states to about 6, after its individual-market membership fell roughly 59% in a year and profits dropped. The company hasn’t published the full list of which states it’s keeping, but confirmed changes so far include exits from Illinois and Ohio’s on-exchange market, while Washington and South Carolina are confirmed to continue. If you’re a Molina Marketplace member, don’t assume your state is one of the six that’s staying.
Key takeaways
- Molina sold ACA Marketplace plans in 14 states in 2026, after already exiting Wisconsin’s marketplace entirely that year, and is cutting to about 6 states for 2027.
- Confirmed 2027 changes include Molina Healthcare of Illinois exiting and Molina leaving Ohio’s on-exchange market, while Molina is continuing in Washington (approved for a 24.4% rate increase) and South Carolina.
- Molina’s Marketplace membership fell to 283,000 by the end of the second quarter of 2026, down from 690,000 a year earlier and 655,000 at the end of 2025.
- Second-quarter 2026 net income was $60 million, down 76% from $255 million a year earlier, which the company attributes largely to keeping more high-cost Marketplace members than it priced for.
- Washington’s insurance commissioner fined Molina Healthcare of Washington $100,000 in March 2024 over enrollment and billing failures that affected exchange members.
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What Molina Healthcare is
Molina Healthcare, Inc. (NYSE: MOH) built its business primarily around Medicaid managed care and expanded into ACA Marketplace plans as a complementary line, typically in the same states where it already runs Medicaid plans. That’s different from Ambetter or Oscar, whose Marketplace business is more central to their identity. Molina’s total company membership, across Medicaid, Medicare and Marketplace plans combined, was about 4.9 million as of June 30, 2026. Its Marketplace segment, though, has been the most volatile part of that business over the past year.
Where Molina is cutting back for 2027
Molina is reducing its Marketplace states from 14 to about 6 for 2027, according to the company’s own second-quarter 2026 disclosures, but it hasn’t published the specific list of which states are staying and which are leaving. Here’s what’s been confirmed state by state so far.
| State | Status for 2027 |
|---|---|
| Illinois | Exiting (Molina Healthcare of Illinois) |
| Ohio | Exiting the on-exchange market; AmeriHealth Caritas is entering |
| Washington | Continuing, approved for a 24.4% rate increase |
| South Carolina | Continuing |
| Wisconsin | Already exited (left the marketplace entirely for 2026) |
If Molina turns out to be leaving your state, see what to do if your insurance company leaves the Marketplace for the process, and start comparing other insurers’ 2027 plans in your area during open enrollment rather than waiting to find out. Members in Washington and Ohio can see how overall costs compare in Washington state and Ohio.
Why Molina is pulling back: the numbers behind the decision
Molina’s Marketplace membership fell to 283,000 by the end of the second quarter of 2026, down from 690,000 a year earlier and 655,000 at the end of 2025, a drop of roughly 59% in a year. Company-wide second-quarter 2026 net income was $60 million, down 76% from $255 million in the same quarter of 2025. Molina’s Marketplace-specific medical loss ratio, the share of premiums paid out in claims, rose to 88.9% in the second quarter of 2026 from 85.4% a year earlier; the company’s overall medical loss ratio across all its business lines was a separate figure, 92.2% versus 90.4% a year earlier, so don’t treat those two ratios as the same number. CEO Joseph Zubretsky has said Molina kept more high-acuity Marketplace members than expected, including people on expensive HIV and cancer medications, and that a roughly 30% average rate increase already built into 2026 pricing wasn’t enough given how risk-adjustment payments worked out. Going forward, the company says it will put less capital into the Marketplace business until it’s convinced the market has stabilized, and expects about $1 billion less in ACA premium revenue as a result of the further 2027 cuts.
Complaints and a state fine to know about
On complaints, KFF’s 2024 analysis of ACA claims denials names Molina Healthcare of Mississippi for one detail: 38% of that plan’s denials were coded as “medical necessity,” which describes a category of denial reason, not an overall denial rate. Look up your specific plan’s rating on HealthCare.gov or NCQA’s Report Cards site, and check complaint history through the NAIC’s Consumer Insurance Search. If a claim is denied, how to appeal a health insurance claim denial walks through the process. One regulatory action to know about: Washington’s insurance commissioner fined Molina Healthcare of Washington $100,000 in March 2024 for enrollment and billing failures tied to a 2021 systems transition, which affected thousands of exchange members through wrong invoices, incorrectly shown balances, and, in 55 cases, members wrongly terminated for non-payment. Commissioner Mike Kreidler said the system in place “did not provide that assurance for thousands of people, adding confusion and stress.”
Pros and cons
Pros
- Molina often runs in the same states as its Medicaid plans, which can mean continuity of care if your income or plan type changes.
- Washington and South Carolina are confirmed to continue for 2027, so members there have more certainty than in states not yet named.
- Company-wide, Molina is still a large insurer, with about 4.9 million members across Medicaid, Medicare and Marketplace plans.
Cons
- Molina hasn’t published its full 2027 state list, so many members can’t confirm their status yet.
- Marketplace membership fell nearly 59% in a year, and profitability in that segment has deteriorated sharply.
- A 2024 Washington state fine over enrollment and billing failures that affected exchange members.
Other insurer guides: Ambetter, Blue Cross Blue Shield, Cigna, Kaiser Permanente, Oscar and UnitedHealthcare. See also the best health insurance companies.
Check 2027 plans from other insurers in your area in case Molina is leaving: compare quotes by ZIP code.
Frequently asked questions
Is Molina leaving my state’s Marketplace in 2027?
Molina is cutting from 14 states to about 6, but the full list hadn’t been published as of late September 2026. Illinois and Ohio’s on-exchange market are confirmed exits; Washington and South Carolina are confirmed to continue. Check your own state during open enrollment.
Why is Molina leaving so many Marketplace states?
The company says it kept more high-cost members than it priced for, including people on expensive HIV and cancer medications, and that its 2026 rate increase wasn’t enough to cover it. It’s now allocating less capital to the Marketplace business until the market stabilizes.
Is Molina Healthcare in financial trouble?
Its Marketplace business has struggled and its company-wide net income dropped 76% in the second quarter of 2026, but Molina still serves about 4.9 million members across Medicaid, Medicare and Marketplace plans and describes the ACA pullback as a deliberate decision rather than a sign of insolvency.
What happened with Molina’s Washington state fine?
Washington’s insurance commissioner fined Molina Healthcare of Washington $100,000 in March 2024 over enrollment and billing system failures, including wrong invoices and improper coverage terminations, that followed a 2021 systems transition.
Sources
- KFF: How has insurer participation in the ACA Marketplaces changed in 2026?
- Becker’s Payer Issues: Molina raises earnings guidance as profits drop 76% in Q2
- Fierce Healthcare: Molina Healthcare plans more marketplace exits as ACA segment falters
- Becker’s Payer Issues: 6 insurers exiting ACA markets
- WA Office of the Insurance Commissioner: Kreidler fines Molina Healthcare $100,000 for enrollment and billing errors
- HealthCare.gov: Quality ratings
This article is general information, not insurance or legal advice. Molina’s full 2027 state list wasn’t published as of this writing, so confirm your own state’s availability directly. Last reviewed September 2026.