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

Historical 90% win rate implies 10% loss rate per RFP. With WA RFP expected in 2026 and possible other renewals, the question is whether ANY of the four specific high-value states go bad. Even if 2-3 RFPs occur across these states, base rate suggests ~10-15% chance of at least one loss.

Virginia loss in Q3 2025 demonstrates contract loss risk is real and recent. WA RFP in 2026 creates specific catalyst. State agencies function as monopsonist buyers with pricing pressure. OBBBA may change procurement dynamics, increasing state scrutiny. With 2-3 potential RFP cycles in top-4 states, compound probability of at least one loss rises above base rate.

90% win rate over many years is strong, and Virginia was NOT a top-4 state. CA, TX, WA, NY are Molina's largest and most strategically important markets—likely to receive disproportionate management focus and competitive advantages from scale. 21-state diversification provides operational expertise. Losing a flagship state would be much rarer than losing a smaller market like Virginia.

Base rate of 10% loss per RFP is established. WA RFP creates concrete 2026 catalyst with 790K members at risk. States are facing budget pressure and may be more willing to switch vendors for cost savings. However, 90% win rate reflects Molina's competitive strength in Medicaid operations. Probability reflects base rate applied to 1-2 likely RFP cycles in top-4 states.

Virginia loss is a recent negative indicator. WA RFP timing creates specific 2026 exposure. OBBBA implementation may cause states to restructure contracts or change vendor mix. MCR challenges (Medicaid 90.5%, consolidated 92.6%) suggest Molina may struggle to remain competitive on pricing while maintaining profitability. Higher probability reflects multiple potential catalysts.

90% win rate is a strong historical baseline. Top-4 states represent core markets with long-standing relationships and operational scale advantages. While WA RFP creates risk, Molina's 790K member scale in WA provides incumbency advantage. Virginia was a smaller, less strategic market. Estimate ~10-12% risk reflecting base rate with modest adjustment for one major RFP cycle.

Base rate of 10% per RFP. WA RFP in 2026 is the primary known catalyst. Virginia loss shows it can happen. Committee stated major contract loss would be classification-changing, highlighting the severity but not increasing the likelihood. Estimate reflects roughly one major RFP with base rate loss probability.

Virginia loss is recent (Q3 2025). WA RFP expected in 2026 creates specific risk. Unclear how many other top-4 RFPs occur in 2026. If 2-3 RFPs across CA/TX/WA/NY, compound probability of at least one loss rises to ~18-25% range. State budget constraints post-pandemic may increase vendor switching.

90% win rate is established over many years. Top-4 states are core markets unlikely to be lost without major operational failures. WA RFP is one event. Base rate of ~10% per RFP seems appropriate. Conservative estimate at lower bound given strategic importance of these specific markets vs smaller states like Virginia.