Workers across the nation are in the thick of changing, renewing, or signing up for certain health care plans under the current open enrollment period. Millions of people could and actually very likely will see their insurance premiums rise pretty sharply next year. Joining us right now with insights on the current state of the health insurance industry is Mark Berlini. He is the CEO of Oscar Health. He's also the new chairman of Verizon and the former chairman and CEO of Etna, a longtime friend of the show ...

Core Insights - Molina Healthcare experienced a significant stock decline of over 17% following its quarterly earnings report, contrasting with a positive market trend where the S&P 500 gained 0.6% [1] Financial Performance - In Q3, Molina's total revenue reached nearly $11.5 billion, marking an 11% year-over-year increase, but net income fell sharply to $97 million ($1.84 per share) from $347 million in the previous year [2][3] - The company surpassed the average analyst revenue estimate of $10.94 billion but significantly missed the consensus for adjusted net income, which was projected at $3.91 per share [3] Business Segments - CEO Joseph Zubretsky indicated that approximately half of the company's underperformance was attributed to the marketplace business, while Medicaid maintained strong margins despite some pressure [3] Future Guidance - Molina revised its 2025 guidance, slightly increasing the revenue forecast to $44.5 billion but lowering the adjusted net profit estimate to $742 million, or about $14 per share, which still falls short of analyst expectations of just under $45.6 billion and $18.62 per share [4][6]

Core Viewpoint - Molina Healthcare's stock plummeted over 20% following a significant earnings miss for Q3, attributed to rising medical expenses and a lowered guidance for Q4 [1][2]. Financial Performance - Molina's adjusted EPS for Q3 was $1.84, missing analyst expectations of $3.89 by more than 50% [2]. - The company projects Q4 adjusted earnings of $0.35, significantly below analysts' expectations of $2.42 [2]. Medical Care Ratio (MCR) - Molina's consolidated MCR for Q3 was 92.6%, up from 89.2% in the same quarter last year, indicating increased medical expenses impacting profitability [4]. - A 92.6% MCR means the company retained only 7.4 cents per dollar of premium revenue after covering medical expenses [5]. - The MCR for ACA plans was particularly high at 95.6%, exceeding both analyst predictions of 86% and Molina's own 73% from the previous year [6]. Industry Context - The MCR is a critical metric for healthcare providers, reflecting the balance between premium revenue and medical expenses [3]. - Rising medical costs and the structure of ACA plans have posed significant challenges for Molina, affecting its financial stability [5][6].

Core Viewpoint - Centene experienced a significant drop in stock price, closing down over 40% on July 2, resulting in a loss of over $11 billion in market capitalization, with competitors also facing declines [1][2][5] Group 1: Financial Impact - The drop in Centene's shares was primarily due to the withdrawal of its 2025 full-year guidance, indicating a more challenging financial outlook [2][4] - The company received data indicating lower growth in the ACA exchange market and higher morbidity among enrollees, leading to fewer and sicker patients [3][4] - The expected impact on Centene's 2025 diluted earnings per share (EPS) is a reduction of $2.75, which is 38% of the previously expected EPS of greater than $7.25 [4][5] Group 2: Market Valuation - Despite the significant stock sell-off, Wall Street analysts see a more attractive valuation for Centene, with a 12-month price target of $68.87, implying a potential upside of 108.31% from the current price [5][6] - The average price target post-guidance withdrawal is $51, suggesting a 53% upside, which is higher than the 32% average upside prior to the drop [6][7] Group 3: Regulatory Environment - The recent legislation signed into law includes $1 trillion in cuts to Medicaid, which accounted for approximately 46% of Centene's revenue last quarter, potentially leading to 10.3 million to 11.8 million fewer Medicaid recipients over the next decade [8][9] - The reduction in expected Medicaid users could have a more significant and lasting impact on Centene compared to the ACA exchange enrollment issues, which only made up 20% of the firm's total revenue last quarter [9]