Will Molina Healthcare lose a major state Medicaid contract (CA/TX/WA/NY) in 2026?

No new contract losses disclosed in Q1 2026 and management is actively winning new business (Florida CMS Kids, HIDE/FIDE conversions). The CA/IL/NY/TX Medicaid attrition is explicitly eligibility-driven (UIS policy) rather than contract-driven — a critical distinction for resolution criteria. Washington RFP remains the key test but awards likely land after Dec 31, 2026 resolution window. Slightly below prior 14% given zero contract-event disclosure narrows remaining window to ~8 months.

Maintaining near prior 14% estimate. Q1 provided no new negative data on contract retention, and the UIS-driven attrition is a distinct phenomenon that does not meet resolution criteria (failure to win re-procurement, non-renewal, or state-initiated termination). However, state budget pressures from OBBBA persist and WA HCA RFP is the single largest pending test with 790K members at risk. The 90% historical win rate implies base rate ~10% for any single RFP cycle — adjusted up slightly for Virginia precedent and structural concentration.

Holding at prior 14% — Q1 data is essentially confirming the prior base case. Zero new contract losses disclosed despite Reg FD obligations to announce material state procurement developments. Management tone is one of active expansion (Florida CMS Kids, HIDE/FIDE outperforming) rather than defensive posture. The WA RFP remains the key binary event, but even if Molina were to lose, award timing typically lands outside the Dec 31, 2026 resolution boundary for a Jan 2027 contract start.

Slight tilt above prior given state budget pressures remain and CA is in active eligibility-policy disruption mode. While UIS attrition doesn't meet resolution criteria, the instability of the policy environment in Molina's largest state (1.2M members) is a reminder of structural vulnerability. OBBBA Medicaid cuts could pressure states to reopen procurements seeking lower-cost bidders. However, no concrete contract-loss signal in Q1 caps the upward adjustment.

A mild upward tilt is warranted. The 6% Medicaid attrition guide (up from 2%) signals a much more disruptive state-level environment than previously assumed. Even if UIS is explicitly eligibility-driven, the underlying state budget and policy pressure is the same force that can push procurement decisions. States scrambling to cut Medicaid costs may use procurement cycles as a lever. Virginia precedent + WA RFP + active state budget stress pushes probability slightly higher than 14%.

Holding close to prior 14%. The Q1 update is meaningfully reassuring on contract retention — zero losses disclosed, UIS attrition is explicitly eligibility-driven not contract-driven, and Molina is winning new contracts (Florida CMS Kids). Management's active expansion posture is inconsistent with a pending major loss. Small upward tilt reflects continued state budget pressure and the genuinely unresolved Washington RFP, which remains the single largest concrete 2026 retention test.

No new contract losses in Q1 2026. Management winning new business (Florida CMS Kids). UIS attrition in CA/IL/NY/TX is eligibility-driven, not contract loss. Washington RFP remains the key 2026 test. Maintaining prior 14% base case.

Slight uptick vs prior. State budget pressures are real and Medicaid attrition of 6% (up from 2%) shows severe state-level disruption. While UIS doesn't meet resolution criteria, the same cost-cutting pressures can affect procurement decisions. Washington RFP with 790K members is unresolved.

Slight decrease from prior. Q1 showed zero contract losses and management actively expanding. 8 months remaining in resolution window narrows the probability envelope. WA RFP awards for Jan 2027 contract may land after Dec 31, 2026 cutoff.