Payer Overview
Molina Healthcare Inc Group Market Analysis: Market Share and Coverage by State
Molina Healthcare Inc Group is a national Medicaid-centric payer with targeted state dominance and a focused footprint. The payer combines regional market strength with a compact national presence, relevant for provider network strategy and contracting.
Payer Overview
Molina Healthcare Inc Group is the #9 largest US A&H payer by reported premium, writing $30.3B in the US market with a US market share of 2.11% across 20 states. The company serves an estimated 4.54M members and operates through 20 affiliated subsidiaries, positioning it as a meaningful regional player with selective national reach.
Molina Healthcare Inc Group also maintains a modest US territory presence of $3.27M across 1 territory (Puerto Rico), which sits separately from its US premium footprint. This geography-focused footprint concentrates exposure in a set of states where Molina holds elevated market positions while keeping limited non-US exposure.
20 rows
| Subsidiary | Domicile |
|---|---|
| Molina Healthcare of Arizona Inc | AZ |
| Molina Healthcare of Florida Inc | FL |
| Molina Healthcare of Illinois Inc | IL |
| Molina Healthcare of Iowa Inc | IA |
| Molina Healthcare of Kentucky Inc | KY |
| Molina Healthcare of Michigan | MI |
| Molina Healthcare of Mississippi Inc | MS |
| Molina Healthcare of Nebraska Inc | NE |
| Molina Healthcare of Nevada Inc | NV |
| Molina Healthcare of New Mexico | NM |
| Molina Healthcare of Ohio Inc | OH |
| Molina Healthcare of Pr Inc | PR |
| Molina Healthcare of South Carolina Inc | SC |
| Molina Healthcare of Texas Inc | TX |
| Molina Healthcare of Texas Insurance Company | TX |
Showing 1–15 of 20
National Market Presence
National Market Footprint
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| AZ | 0.88% | $192M | 42.8K |
| FL | 0.87% | $1.12B | 127K |
| IA | 9.4% | $1.51B | 227K |
| ID | 5.21% | $336M | 72.2K |
| IL | 3.98% | $2.52B | 364K |
| KY | 8.22% | $2.10B | 240K |
| MA | 0.01% | $4.95M | 763 |
| MI | 4.41% | $2.24B | 320K |
| MS | 5.43% | $656M | 103K |
| NE | 9.0% | $816M | 144K |
| NM | 1.71% | $198M | 19.4K |
| NV | 2.96% | $380M | 61.7K |
| NY | 2.16% | $1.77B | 299K |
| OH | 5.24% | $3.16B | 430K |
| TX | 3.45% | $4.89B | 669K |
| UT | 3.99% | $459M | 112K |
| VA | 2.81% | $1.18B | 181K |
| WA | 13.52% | $4.53B | 767K |
| WI | 4.44% | $1.23B | 203K |
| SC | 4.35% | $995M | 158K |
| National Total | — | $30.3B | 4.54M |
Molina Healthcare Inc Group shows concentrated premium exposure in a limited set of states. The largest premiums are in WA ($4.53B), TX ($4.89B), and OH ($3.16B), while estimated membership is similarly concentrated with large pools in WA (767K), TX (669K), and OH (430K). This concentration implies that national provider negotiations with Molina will be most impactful in those high-volume states and that network leverage will vary materially by state.
From a contracting perspective, providers should prioritize relationship and rate negotiations in Washington, Texas, and Ohio where Molina's premium and membership footprints are largest. In lower-premium states such as Massachusetts ($4.95M) and New Mexico ($198M), Molina's influence on regional rate benchmarks will be limited.
State-by-State Market Position
Molina Healthcare Inc Group's strongest presence is in the West and parts of the Midwest and South. The West shows particular strength with Washington at 13.52% market share and premium of $4.53B, while the Midwest features elevated positions in Iowa (9.4%, $1.51B) and Nebraska (9.0%, $816M). The Southeast and Mid-Atlantic have meaningful but smaller footprints, including Kentucky (8.22%, $2.10B) and South Carolina (4.35%, $995M).
For multi-state provider groups, this geographic distribution means negotiating strategies should be tailored: regional groups with a strong West presence will find Molina a dominant counterparty in Washington, whereas groups concentrated in the Northeast will see Molina as a more modest partner. Providers that can demonstrate cross-state volume in Molina's high-premium states will have more leverage for constructive, standardized contracting.
Estimated Member Demographics
Molina Healthcare covers an estimated 4,328,082 members nationally, based on Census and NAIC market share data. The table below breaks down the estimated membership by age band:
| Age Band | Estimated Members |
|---|---|
| Under 6 | 264,463 |
| 6 to 18 | 682,848 |
| 19 to 25 | 407,558 |
| 26 to 34 | 551,300 |
| 35 to 44 | 625,964 |
| 45 to 54 | 593,779 |
| 55 to 64 | 603,802 |
| 65 to 74 | 349,972 |
| 75 plus | 248,395 |
The largest age bands are 6 to 18 (682,848 members), 35 to 44 (625,964), 55 to 64 (603,802), and 45 to 54 (593,779). This distribution highlights Molina's strong presence among families, working-age adults, and a significant senior segment.
This demographic mix suggests that Molina's covered population will generate demand for a wide range of healthcare services, from pediatric and adolescent care to chronic disease management and geriatric services. Providers should be prepared for a balanced mix of preventive, acute, and chronic care needs across the age spectrum.
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