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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31,September 30, 2020
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from             to             
Commission file number: 001-31719
moh-20200930_g1.jpg
MOLINA HEALTHCARE, INC.
(Exact name of registrant as specified in its charter)
Delaware13-4204626
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
200 Oceangate, Suite 100
Long Beach,California90802
(Address of principal executive offices)(Zip Code)
(562) (562) 435-3666
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $0.001 Par ValueMOHNew York Stock Exchange
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes      No  
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes      No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large Accelerated Filer   Accelerated Filer Non-Accelerated Filer Smaller reporting company Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes   No  
The number of shares of the issuer’s Common Stock, $0.001 par value, outstanding as of April 24,October 23, 2020, was approximately 59,200,000.59,300,000.



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MOLINA HEALTHCARE, INC. FORM 10-Q
FOR THE QUARTERLY PERIOD ENDED MARCH 31,SEPTEMBER 30, 2020

TABLE OF CONTENTS
ITEM NUMBERPage
PART I
1.
2.
3.
4.
PART II
1.
1A.
2.
3.Defaults Upon Senior SecuritiesNot Applicable.
4.Mine Safety DisclosuresNot Applicable.
5.Other InformationNot Applicable.
6.

ITEM NUMBERPage
   
PART I 
   
1.
   
2.
   
3.
   
4.
   
PART II
 
   
1.
   
1A.
   
2.
   
3.Defaults Upon Senior SecuritiesNot Applicable.
   
4.Mine Safety DisclosuresNot Applicable.
   
5.Other InformationNot Applicable.
   
6.
   
 
   
   


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CONSOLIDATED STATEMENTS OF INCOME
Three Months Ended September 30,Nine Months Ended September 30,
Three Months Ended March 31,2020201920202019
2020 2019
(In millions, except per-share amounts)
(Unaudited)
(In millions, except per-share amounts)
(Unaudited)
Revenue:   Revenue:
Premium revenue$4,304
 $3,952
Premium revenue$4,768 $4,084 $13,444 $12,085 
Premium tax revenue150
 138
Premium tax revenue170 119 477 367 
Health insurer fees reimbursed66
 
Health insurer fees reimbursed69 206 
Investment income and other revenue29
 29
Investment income and other revenue14 40 61 103 
Total revenue4,549
 4,119
Total revenue5,021 4,243 14,188 12,555 
Operating expenses:   Operating expenses:
Medical care costs3,716
 3,371
Medical care costs4,098 3,523 11,412 10,360 
General and administrative expenses317
 302
General and administrative expenses368 323 1,030 953 
Premium tax expenses150
 138
Premium tax expenses170 119 477 367 
Health insurer fees68
 
Health insurer fees70 209 
Depreciation and amortization20
 25
Depreciation and amortization23 21 64 68 
Other4
 3
Other
Total operating expenses4,275
 3,839
Total operating expenses4,732 3,986 13,201 11,753 
Operating income274
 280
Operating income289 257 987 802 
Other expenses, net:   Other expenses, net:
Interest expense21
 23
Interest expense27 22 72 67 
Other income, net
 (3)
Other expense (income), netOther expense (income), net(15)
Total other expenses, net21
 20
Total other expenses, net27 24 77 52 
Income before income tax expense253
 260
Income before income tax expense262 233 910 750 
Income tax expense75
 62
Income tax expense77 58 271 181 
Net income$178
 $198
Net income$185 $175 $639 $569 
   
Net income per share - Basic$2.95
 $3.19
Net income per share - Basic$3.14 $2.81 $10.80 $9.15 
Net income per share - Diluted$2.92
 $2.99
Net income per share - Diluted$3.10 $2.75 $10.65 $8.80 


CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
Three Months Ended September 30,Nine Months Ended September 30,
Three Months Ended March 31,2020201920202019
2020 2019
(In millions)
(Unaudited)
(In millions)
(Unaudited)
Net income$178
 $198
Net income$185 $175 $639 $569 
Other comprehensive (loss) income:   
Unrealized investment (loss) income(25) 7
Other comprehensive income:Other comprehensive income:
Unrealized investment incomeUnrealized investment income43 17 
Less: effect of income taxes(6) 2
Less: effect of income taxes10 
Other comprehensive (loss) income, net of tax(19) 5
Other comprehensive income, net of taxOther comprehensive income, net of tax33 13 
Comprehensive income$159
 $203
Comprehensive income$190 $175 $672 $582 
See accompanying notes.

Molina Healthcare, Inc. September 30, 2020 Form 10-Q | 3

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CONSOLIDATED BALANCE SHEETS
September 30,
2020
December 31,
2019
March 31,
2020
 December 31,
2019
(Dollars in millions,
except per-share amounts)
(Dollars in millions,
except per-share amounts)
(Unaudited)  (Unaudited)
ASSETSASSETSASSETS
Current assets:   Current assets:
Cash and cash equivalents$2,365
 $2,452
Cash and cash equivalents$3,196 $2,452 
Investments2,010
 1,946
Investments1,769 1,946 
Receivables1,603
 1,406
Receivables1,775 1,406 
Prepaid expenses and other current assets346
 163
Prepaid expenses and other current assets213 163 
Total current assets6,324
 5,967
Total current assets6,953 5,967 
Property, equipment, and capitalized software, net385
 385
Property, equipment, and capitalized software, net395 385 
Goodwill and intangible assets, net168
 172
Goodwill and intangible assets, net265 172 
Restricted investments82
 79
Restricted investments93 79 
Deferred income taxes71
 79
Deferred income taxes74 79 
Other assets99
 105
Other assets101 105 
Total assets$7,129
 $6,787
Total assets$7,881 $6,787 
   
LIABILITIES AND STOCKHOLDERS’ EQUITYLIABILITIES AND STOCKHOLDERS’ EQUITYLIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:   Current liabilities:
Medical claims and benefits payable$1,981
 $1,854
Medical claims and benefits payable$2,289 $1,854 
Amounts due government agencies777
 664
Amounts due government agencies640 664 
Accounts payable, accrued liabilities and other743
 484
Accounts payable, accrued liabilities and other566 502 
Deferred revenue43
 249
Deferred revenue61 249 
Current portion of long-term debt26
 18
Total current liabilities3,570
 3,269
Total current liabilities3,556 3,269 
Long-term debt1,596
 1,237
Long-term debt1,813 1,237 
Finance lease liabilities229
 231
Finance lease liabilities226 231 
Other long-term liabilities87
 90
Other long-term liabilities85 90 
Total liabilities5,482
 4,827
Total liabilities5,680 4,827 
Stockholders’ equity:   Stockholders’ equity:
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 59 million shares at March 31, 2020, and 62 million shares at December 31, 2019
 
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding
 
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 59 million shares at September 30, 2020, and 62 million shares at December 31, 2019Common stock, $0.001 par value, 150 million shares authorized; outstanding: 59 million shares at September 30, 2020, and 62 million shares at December 31, 2019
Preferred stock, $0.001 par value; 20 million shares authorized, 0 shares issued and outstandingPreferred stock, $0.001 par value; 20 million shares authorized, 0 shares issued and outstanding
Additional paid-in capital140
 175
Additional paid-in capital181 175 
Accumulated other comprehensive (loss) income(15) 4
Accumulated other comprehensive incomeAccumulated other comprehensive income37 
Retained earnings1,522
 1,781
Retained earnings1,983 1,781 
Total stockholders’ equity1,647
 1,960
Total stockholders’ equity2,201 1,960 
Total liabilities and stockholders’ equity$7,129
 $6,787
Total liabilities and stockholders’ equity$7,881 $6,787 
See accompanying notes.

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CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
Common StockAdditional
Paid-in
Capital
Accumulated
Other
Comprehensive
Income (Loss)
Retained
Earnings
Total
OutstandingAmount
(In millions)
(Unaudited)
Balance at December 31, 201962 $$175 $$1,781 $1,960 
Net income— — — — 178 178 
Common stock purchases(3)— (9)— (437)(446)
Termination of warrants— — (30)— — (30)
Other comprehensive loss, net— — — (19)— (19)
Share-based compensation— — — — 
Balance at March 31, 202059 140 (15)1,522 1,647 
Net income— — — — 276 276 
Other comprehensive income, net— — — 47 — 47 
Share-based compensation— — 26 — — 26 
Balance at June 30, 202059 166 32 1,798 1,996 
Net income— — — — 185 185 
Other comprehensive income, net— — — — 
Share-based compensation— — 15 — — 15 
Balance at September 30, 202059 $$181 $37 $1,983 $2,201 
 Common Stock 
Additional
Paid-in
Capital
 
Accumulated
Other
Comprehensive
Income (Loss)
 
Retained
Earnings
 Total
 Outstanding Amount    
 (In millions)
 (Unaudited)
Balance at December 31, 201962
 $
 $175
 $4
 $1,781
 $1,960
Net income
 
 
 
 178
 178
Common stock purchases(3) 
 (9) 
 (437) (446)
Termination of warrants
 
 (30) 
 
 (30)
Other comprehensive loss, net
 
 
 (19) 
 (19)
Share-based compensation
 
 4
 
 
 4
Balance at March 31, 202059
 $
 $140
 $(15) $1,522
 $1,647



Common StockAdditional
Paid-in
Capital
Accumulated
Other
Comprehensive
Income (Loss)
Retained
Earnings
Total
Common Stock 
Additional
Paid-in
Capital
 
Accumulated
Other
Comprehensive
Loss
 
Retained
Earnings
 TotalOutstandingAmount
Outstanding Amount 
(In millions)(In millions)
(Unaudited)(Unaudited)
Balance at December 31, 201862
 $
 $643
 $(8) $1,012
 $1,647
Balance at December 31, 201862 $$643 $(8)$1,012 $1,647 
Net income
 
 
 
 198
 198
Net income— — — — 198 198 
Adoption of new accounting standard
 
 
 
 85
 85
Adoption of new accounting standard— — — — 85 85 
Partial termination of warrants
 
 (103) 
 
 (103)Partial termination of warrants— — (103)— — (103)
Other comprehensive income, net
 
 
 5
 
 5
Other comprehensive income, net— — — — 
Share-based compensation1
 
 3
 
 
 3
Share-based compensation— — — 
Balance at March 31, 201963
 $
 $543
 $(3) $1,295
 $1,835
Balance at March 31, 201963 543 (3)1,295 1,835 
Net incomeNet income— — — — 196 196 
Partial termination of warrantsPartial termination of warrants— — (321)— — (321)
Other comprehensive income, netOther comprehensive income, net— — — — 
Share-based compensationShare-based compensation— — 18 — — 18 
Balance at June 30, 2019Balance at June 30, 201963 240 1,491 1,736 
Net incomeNet income— — — — 175 175 
Partial termination of warrantsPartial termination of warrants— — (90)— — (90)
Share-based compensationShare-based compensation— — 10 — — 10 
Balance at September 30, 2019Balance at September 30, 201963 $$160 $$1,666 $1,831 
See accompanying notes.

Molina Healthcare, Inc. September 30, 2020 Form 10-Q | 5

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CONSOLIDATED STATEMENTS OF CASH FLOWS
Nine Months Ended September 30,
 20202019
(In millions)
(Unaudited)
Operating activities:
Net income$639 $569 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization64 68 
Deferred income taxes(3)
Share-based compensation43 29 
Loss (gain) on debt repayment(15)
Other, net
Changes in operating assets and liabilities:
Receivables(369)50 
Prepaid expenses and other current assets(98)(6)
Medical claims and benefits payable431 14 
Amounts due government agencies(24)(355)
Accounts payable, accrued liabilities and other55 37 
Deferred revenue(188)(4)
Income taxes34 
Net cash provided by operating activities591 398 
Investing activities:
Purchases of investments(670)(1,938)
Proceeds from sales and maturities of investments891 1,890 
Net cash paid in business combinations(62)
Purchases of property, equipment and capitalized software(64)(30)
Other, net(2)
Net cash provided by (used in) investing activities98 (80)
Financing activities:
Proceeds from senior notes offering, net of issuance costs789 
Repayment of term loan facility(600)
Common stock purchases(453)
Proceeds from borrowings under term loan facility380 220 
Cash paid for partial termination of warrants(30)(514)
Cash paid for partial settlement of conversion option(27)(578)
Cash received for partial settlement of call option27 578 
Repayment of principal amount of convertible senior notes(12)(240)
Other, net(5)24 
Net cash provided by (used in) financing activities69 (510)
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents758 (192)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period2,508 2,926 
Cash, cash equivalents, and restricted cash and cash equivalents at end of period$3,266 $2,734 
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 Three Months Ended March 31,
 2020 2019
 (In millions)
(Unaudited)
Operating activities:   
Net income$178
 $198
Adjustments to reconcile net income to net cash provided by operating activities:   
Depreciation and amortization20
 25
Deferred income taxes14
 15
Share-based compensation12
 9
Gain on debt repayment
 (3)
Other, net(3) 6
Changes in operating assets and liabilities:   
Receivables(197) (29)
Prepaid expenses and other current assets(229) 20
Medical claims and benefits payable127
 34
Amounts due government agencies113
 (35)
Accounts payable, accrued liabilities and other247
 (30)
Deferred revenue(206) (4)
Income taxes60
 43
Net cash provided by operating activities136
 249
Investing activities:   
Purchases of investments(578) (185)
Proceeds from sales and maturities of investments493
 366
Purchases of property, equipment and capitalized software(21) (6)
Other, net3
 (4)
Net cash (used in) provided by investing activities(103) 171
Financing activities:   
Common stock purchases(453) 
Proceeds from borrowings under term loan facility380
 100
Cash paid for partial termination of warrants(30) (103)
Cash paid for partial settlement of conversion option(27) (115)
Cash received for partial settlement of call option27
 115
Repayment of principal amount of convertible senior notes(12) (46)
Other, net(3) 1
Net cash used in financing activities(118) (48)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents(85) 372
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period2,508
 2,926
Cash, cash equivalents, and restricted cash and cash equivalents at end of period$2,423
 $3,298


CONSOLIDATED STATEMENTS OF CASH FLOWS
(continued)
Nine Months Ended September 30,
Three Months Ended March 31,20202019
2020 2019
(In millions)
(Unaudited)
(In millions)
(Unaudited)
Supplemental cash flow information:   Supplemental cash flow information:
   
Schedule of non-cash investing and financing activities:   Schedule of non-cash investing and financing activities:
Common stock used for share-based compensation$(7) $(7)Common stock used for share-based compensation$(8)$(7)
   
Details of business combinations:Details of business combinations:
Fair value of assets acquiredFair value of assets acquired$(106)$
Fair value of contingent consideration liabilitiesFair value of contingent consideration liabilities40 
Fair value of liabilities assumedFair value of liabilities assumed
Net cash paid in business combinationsNet cash paid in business combinations$(62)$
Details of change in fair value of derivatives, net:   Details of change in fair value of derivatives, net:
(Loss) gain on call option$(2) $155
(Loss) gain on call option$(2)$124 
Gain (loss) on conversion option2
 (155)Gain (loss) on conversion option(124)
Change in fair value of derivatives, net$
 $
Change in fair value of derivatives, net$$
See accompanying notes.


Molina Healthcare, Inc. September 30, 2020 Form 10-Q | 7

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
SEPTEMBER 30, 2020
March 31, 2020

1. Organization and Basis of Presentation
Organization and Operations
Molina Healthcare, Inc. provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces (the “Marketplace”). We currently have 2 reportable segments: the Health Plans segment and the Other segment. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.
TheAs of September 30, 2020, the Health Plans segment consistsconsisted of health plans operating in 1415 states and the Commonwealth of Puerto Rico. As of March 31, 2020, these health plansRico, and served approximately 3.44.0 million members eligible for Medicaid, Medicare, and other government-sponsored healthcare programs for low-income families and individuals, including Marketplace members, most of whom receive government subsidies for premiums.premium subsidies. The health plans are generally operated by our respective wholly owned subsidiaries in those states each of which isand licensed as a health maintenance organizationorganizations (“HMO”).
Our state Medicaid contracts typically have terms of three to five years, contain renewal options exercisable by the state Medicaid agency, and allow either the state or the health plan to terminate the contract with or without cause. Such contracts are subject to risk of loss in states that issue requests for proposal (“RFPs”) open to competitive bidding by other health plans. If one of our health plans is not a successful responsive bidder to a state RFP, its contract may not be renewed.
In addition to contract renewal, our state Medicaid contracts may be periodically amended to include or exclude certain health benefits (such as pharmacy services, behavioral health services, or long-term care services); populations such as the aged, blind or disabled; and regions or service areas.
Recent Developments - Health Plans Segment
ReferNew York. In September 2020, we entered into a definitive agreement to acquire substantially all of the assets of Affinity Health Plan, Inc. The net purchase price for the transaction is approximately $380 million, subject to various adjustments at closing, which we intend to fund with cash on hand. We currently expect the transaction to close as early as the second quarter of 2021.
In July 2020, we completed the acquisition of certain assets of YourCare Health Plan, Inc. See Note 11, “Subsequent Events,4, “Business Combinations,” for further information.
Kentucky. In September 2020, we completed the descriptionacquisition of certain assets of Passport Health Plan, Inc. See Note 4, “Business Combinations,” for further information.
In May 2020, our Kentucky health plan had been selected as an awardee pursuant to the statewide Medicaid managed care RFP issued by the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services. On October 23, 2020, pursuant to a protest filing appeal with regard to the RFP awards, a court ordered the addition of a recent acquisition transaction.sixth health plan to the Kentucky Medicaid program for 2021. That ruling did not rescind the Medicaid contract award to our Kentucky health plan for 2021, nor did it have any impact on the earlier novation of the Passport Medicaid contract to us. The new Medicaid contract is currently expected to begin on January 1, 2021.
Acquisition of Magellan Complete Care (“MCC”). In April 2020, we entered into a definitive agreement to acquire the MCC line of business of Magellan Health, Inc. The purchase price for the transaction is approximately $820 million, net of certain tax benefits, which we intend to fund with cash on hand. The transaction is subject to federal and state regulatory approvals, and other customary closing conditions, and is expected to close around the end of 2020. In connection with this transaction, Magellan Health, Inc. has agreed to provide certain transition services following the closing.
Texas. In March 2020, the Texas Health and Human Services Commission (“HHSC”) notified our Texas health plan that HHSC had upheld our protest and had canceled all previously awarded contracts associated with the re-procurement awards announced in October 2019 for the ABD program (known in Texas as “STAR+PLUS”). In addition, HHSC canceled the pending re-procurement associated with the TANF and CHIP programs (known in Texas as “STAR/CHIP”). HHSC further indicated that it was deliberating next steps with respect to both re-procurements.
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Puerto Rico. We have decided to sellwill exit Puerto Rico’s Medicaid program when our Puerto Rico Medicaid business. In doing so, we will workcurrent contract expires on October 31, 2020. We are working closely with the regulatory authorities and the provider community to ensure that our members in Puerto Rico are cared for and have reliable continuity of care.
Texas. On March 25, 2020, the Texas Health and Human Services Commission (“HHSC”) notified our Texas health plan that HHSC has canceled all contracts associated with their ABD program (known in Texas as “STAR+PLUS”) re-procurement awards announced in October 2019, and canceled the solicitation associated with their TANF and CHIP programs (known in Texas as “STAR/CHIP”) re-procurement. HHSC further indicated that it is currently deliberating next steps with respect to both re-procurements. Previously, in October 2019, the HHSC had awarded contracts to our Texas health plan for the STAR+PLUS program in two service areas, consisting of one legacy service area and one new service area. This would have been a reduction from our current footprint of six service areas. Also, in 2019, our Texas health plan submitted an RFP response for STAR/CHIP.
Illinois. In March 2020, we terminated our agreement to acquire all of the capital stock of NextLevel Health Partners, Inc. due to the seller’s stated unwillingness to close pursuant to the terms of the acquisition agreement.
Consolidation and Interim Financial Information
The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the threenine months ended March 31,September 30, 2020, are not necessarily indicative of the results for the entire year ending December 31, 2020.
The unaudited consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read or have access to our audited consolidated financial statements for the fiscal year ended December 31, 2019. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2019, audited consolidated financial statements have been omitted.

These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2019.
Use of Estimates
The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates. Principal areas requiring the use of estimates include:
The determination of medical claims and benefits payable of our Health Plans segment;
Health Plans segment contractual provisions that may limit revenue recognition based upon the costs incurred or the profits realized under a specific contract;
Health Plans segment quality incentives that allow us to recognize incremental revenue if certain quality standards are met;
Settlements under riskrisk- or savings sharingsavings-sharing programs;
Purchase price allocations relating to business combinations, including the determination of contingent consideration;
The assessment of long-lived and intangible assets, and goodwill for impairment;
The determination of reserves for potential absorption of claims unpaid by insolvent providers;
The determination of reserves for the outcome of litigation;
The determination of valuation allowances for deferred tax assets; and
The determination of unrecognized tax benefits.

2.Significant Accounting Policies
Cash and Cash Equivalents
Cash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase. The following table provides a reconciliation ofreconciles cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.
September 30,
 20202019
(In millions)
Cash and cash equivalents$3,196 $2,679 
Restricted cash and cash equivalents70 55 
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows$3,266 $2,734 
 March 31,
 2020 2019
 (In millions)
Cash and cash equivalents$2,365
 $3,224
Restricted cash and cash equivalents58
 74
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows$2,423
 $3,298
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Investments
Our investments are principally held in debt securities, which are grouped into two separate categories for accounting and reporting purposes: available-for-sale securities, and held-to-maturity securities. Available-for-sale (“AFS”) securities are recorded at fair value and unrealized gains and losses, if any, are recorded in stockholders’ equity as other comprehensive income (loss), net of applicable income taxes. Held-to-maturity (“HTM”) securities are recorded at amortized cost, which approximates fair value, and unrealized holding gains or losses are not generally recognized. Realized gains and losses, and unrealized losses arising from credit-related factors with respect to AFS and HTM securities are included in the determination of net income. The cost of securities sold is determined using the specific-identification method.
Our investment policy requires that all our investments have final maturities of less than 10 years, or less than 10 years average life for structured securities. Investments and restricted investments are subject to interest rate risk and will decrease in value if market rates increase. Declines in interest rates over time will reduce our investment income.
In general, our AFS securities are classified as current assets without regard to the securities’ contractual maturity dates because they may be readily liquidated. We monitor our investments for credit-related impairment. For comprehensive discussions of the fair value and classification of our investments, see Note 4, “Fair5, “Fair Value Measurements,,” and Note 5, “Investments.6, “Investments.

Accrued interest receivable relating to our AFS and HTM securities is presented within “Prepaid expenses and other current assets” in the accompanying consolidated balance sheets, and amounted to $11$9 million and $12 million at March 31,September 30, 2020, and December 31, 2019, respectively. We do not measure an allowance for credit losses on accrued interest receivable. Instead, we write off accrued interest receivable that has not been collected within 90 days of the interest payment due date. We recognize such write offs as a reversal of interest income. No accrued interest was written off during the threenine months ended March 31,September 30, 2020.
Premium Revenue Recognition and Premiums Receivable
Premium revenue is generated from our Health Plans segment contracts related to our Medicaid, Medicare and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premiumspremium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. The state Medicaid programs and the federal Medicare program periodically adjust premiums. Additionally, many of our contracts contain provisions that may adjust or limit revenue or profit, as described below. Consequently, we recognize premium revenue as it is earned under such provisions. Liabilities accrued for premiums to be returned under such provisions are recognized as “Amounts due government agencies” in the accompanying consolidated balance sheets, and included the following categories by program:
September 30,
2020
December 31,
2019
(In millions)
Medicaid program:
Minimum MLR and profit sharing$136 $92 
Other83 95 
Medicare program:
Risk adjustment and Part D risk sharing38 14 
Minimum MLR and profit sharing35 36 
Other30 21 
Marketplace program:
Risk adjustment265 368 
Minimum MLR33 15 
Other20 23 
Total amounts due government agencies$640 $664 
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Contractual Provisions That May Adjust or Limit Revenue or Profit
Medicaid Program
Medical Cost Floors (Minimums),Minimum MLR and Medical Cost Corridors. A portion of our premium revenue may be returned if certain minimum amounts are not spent on defined medical care costs. In the aggregate, we recorded liabilities under the terms of such contractUnder certain medical cost corridor provisions, of $74 million at each of March 31, 2020, and December 31, 2019, respectively. Approximately $69 million of the liabilities accrued at each of March 31, 2020, and December 31, 2019, respectively, relate to our participation in Medicaid Expansion programs.
In certain circumstances, the health plans may receive additional premiums if amounts spent on medical care costs exceed a defined maximum threshold. Receivables relating to such provisions were insignificant at March 31, 2020, and December 31, 2019.
Profit Sharing and Profit Ceiling.Sharing. Our contracts with certain states contain profit-sharing or profit ceilingsharing provisions under which we refund amounts to the states if our health plans generate profit above a certain specified percentage. In some cases, we are limited in the amount of administrative costs that we may deduct in calculating the refund, if any. Liabilities for profits in excess of the amount we are allowed to retain under these provisions were insignificant at March 31, 2020, and December 31, 2019.
Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we must adjust our premium revenue in the period in which we learn ofdetermine that the adjustment is probable and reasonably estimable, and is based on our best estimate of the ultimate premium we expect to realize for the period being adjusted.
Various states have implemented temporary premium refunds and related actions in response to the reduced demand for medical services stemming from COVID-19, which are resulting in a reduction of our medical margin. In some cases, these premium actions are retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. In the second quarter of 2020, we recognized approximately $75 million for certain of these retroactive premium actions that we believe to be probable, and where the ultimate premium amount is reasonably estimable. In most of those states, the refund period extended into the third quarter of 2020, and one additional state, Michigan, enacted a premium refund mechanism in the third quarter of 2020. Consequently, we recognized an additional $88 million related to these retroactive premium actions in the third quarter of 2020, resulting in $163 million recognized in the nine months ended September 30, 2020.
It is possible that certain states could increase the level of existing premium refunds, and it is also possible that other states could implement some form of retroactive premium refund during the fourth quarter of 2020. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows.
Medicare Program
Risk Adjusted Premiums.Adjustment. Our Medicare premiums are subject to retroactive increase or decrease based on the health status of our Medicare members (as measured by member risk score). We estimate our members’ risk scores and the related amount of Medicare revenue that will ultimately be realized for the periods presented based on our knowledge of our members’ health status, risk scores and Centers for Medicare and& Medicaid Services (“CMS”) practices. Consolidated balance sheet amounts related to anticipated Medicare risk adjusted premiums and Medicare Part D settlements were insignificant at March 31, 2020, and December 31, 2019.
Minimum MLR. The Affordable Care Act (“ACA”) has established a minimum annual medical loss ratio (“Minimum MLR”) of 85% for Medicare. The medical loss ratio represents medical costs as a percentage of premium revenue. Federal regulations define what constitutes medical costs and premium revenue. If the Minimum MLR is not met, we may be required to pay rebates to the federal government. We recognize estimated rebates under the Minimum MLR as an adjustment to premium revenue in our consolidated statements of income. The amounts payable for the Medicare Minimum MLR were insignificant at March 31, 2020, and December 31, 2019.
Marketplace Program
Refer to NoteRisk Corridor Settlement. 11, “Subsequent Events,” forIn April 2020, the description of a recent United States Supreme Court decision regardingheld that §1342 of the Affordable Care Act obligated the federal government to pay participating insurers the full Marketplace risk corridors.corridor amounts calculated by that statute, and that impacted insurers may sue the federal government in the U.S. Court of Federal Claims to recover damages for breach of that obligation. In June 2020, the Claims Court granted us judgment in the amount of $128.1 million for our 2014, 2015, and 2016 Marketplace risk corridor claims, which we received in October 2020. Since we accounted for the judgment as a gain contingency at September 30, 2020, it will be recognized in our fourth quarter 2020 financial results. The judgment does not create additional Minimum MLR rebates.
Risk Adjustment. Under this program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk adjustment payment into the pool if their composite risk scores are below the average risk score (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score

(risk (risk adjustment receivable). We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income. As of March 31,September 30, 2020, Marketplace risk adjustment payables amounted
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to $456$265 million and related receivables amounted to $76$59 million, for a net payable of $380$206 million. This net payable consisted of $230 million, of which $80 million relates in payables relating to 2020, and $300$24 million relatesin receivables relating primarily to 2019. As of December 31, 2019, Marketplace risk adjustment payables amounted to $368 million and related receivables amounted to $63 million, for a net payable of $305$305 million,, which relatesrelated primarily to 2019 and prior periods.
Minimum MLR. The ACA has established a Minimum MLR of 80% for the Marketplace. If the Minimum MLR is not met, we may be required to pay rebates to our Marketplace policyholders. The Marketplace risk adjustment program is taken into consideration when computing the Minimum MLR. We recognize estimated rebates under the Minimum MLR as an adjustment to premium revenue in our consolidated statements of income. Aggregate balance sheet amounts related to the Minimum MLR were insignificant at March 31, 2020, and December 31, 2019.
A summary of the categories of amounts due government agencies is as follows:
 March 31,
2020
 December 31,
2019
 (In millions)
Medicaid program:   
Medical cost floors and corridors$74
 $74
Other amounts due to states76
 84
Marketplace program:   
Risk adjustment456
 368
Other171
 138
Total amounts due government agencies$777
 $664

Quality Incentives
At many of our health plans, revenue ranging from approximately 1% to 4% of certain health plan premiums is earned only if certain performance measures are met. Such performance measures are generally found in our Medicaid and MMP contracts. As described in Note 1, Organization“Organization and Basis of PresentationPresentation–Use of Estimates,” recognition of quality incentive premium revenue is subject to the use of estimates.
The following table quantifies the quality incentive premium revenue recognized for the periods presented, including the amounts earned in the periods presented and prior periods.
  Three Months Ended March 31,
  2020 2019
 (In millions)
Maximum available quality incentive premium - current period $61
 $45
     
Quality incentive premium revenue recognized in current period:    
Earned current period $44
 $26
Earned prior periods 12
 20
Total $56
 46
     
Quality incentive premium revenue recognized as a percentage of total premium revenue 1.3% 1.2%


 Three Months Ended September 30,Nine Months Ended September 30,
 2020201920202019
(In millions)
Maximum available quality incentive premium - current period$69 $47 $195 $138 
Quality incentive premium revenue recognized in current period:
Earned current period$63 $46 $180 $109 
Earned prior periods19 23 35 
Total$82 $51 $203 144 
Quality incentive premium revenue recognized as a percentage of total premium revenue1.7 %1.2 %1.5 %1.2 %
Receivables
Receivables consist primarily of amounts due from government agencies, which may be subject to potential retroactive adjustments. Because substantially all our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant.
September 30,
2020
December 31,
2019
(In millions)
Government receivables$1,180 $1,056 
Pharmacy rebate receivables175 150 
Health insurer fee reimbursement receivables180 
Other240 195 
Total$1,775 $1,406 
Reinsurance
We bear underwriting and reserving risks associated with our health plan subsidiaries. Until the second quarter of 2020, we limited our risk of catastrophic losses solely by maintaining high deductible reinsurance coverage with a highly-rated, unaffiliated insurance company (the “third-party reinsurer”). Beginning in the second quarter of 2020, we now retain certain of these risks through our wholly-owned, captive insurance subsidiary (the “captive”). We continue to reduce our exposure to significant catastrophic losses by insuring levels of coverage, with the third-party reinsurer, for losses in excess of what we retain with the captive. Because we remain liable to our policyholders in the event the third-party reinsurer is unable to pay its portion of the losses, we continually monitor the third-party reinsurer’s financial condition, including its ability to maintain high credit ratings. We report reinsurance premiums as
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 March 31,
2020
 December 31,
2019
 (In millions)
Government receivables$1,167
 $1,056
Pharmacy rebate receivables160
 150
Health insurer fee reimbursement receivables71
 5
Other205
 195
Total$1,603
 $1,406
a reduction to premium revenue, while related reinsurance recoveries are reported as a reduction to medical care costs. Intercompany transactions with our captive are eliminated in consolidation.

Premium Deficiency Reserves on Loss Contracts
We assess the profitability of our medical care policies to identify groups of contracts where current operating results or forecasts indicate probable future losses. If anticipated future variable costs exceed anticipated future premiums and investment income, a premium deficiency reserve is recognized. In the third quarter of 2020, we recognized a premium deficiency reserve of $10 million for our Medicaid contract in Puerto Rico. As described in Note 1, “Organization and Basis of Presentation,” we will exit Puerto Rico’s Medicaid program when our current contract expires on October 31, 2020. No premium deficiency reserve was recorded as of December 31, 2019.
Concentrations of Credit Risk
Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 10 years, or less than 10 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and governments of each state or commonwealth in which our health plan subsidiaries operate.
Health Insurer Fee
Under the Affordable Care Act,ACA, the federal government imposes an annual fee, or excise tax, on health insurers for each calendar year (the “HIF”). Public Law No. 115-120 provided for a HIF moratorium in 2019; therefore, there was no HIF incurred or reimbursed in that year. The HIF iswas reinstated in 2020, but the Further Consolidated Appropriations Act, 2020, repealed the HIF effective for years after 2020. The HIF is allocated to health insurers based on each health insurer's share of net premiums for all U.S. health insurers in the year preceding the assessment. Our estimated HIF liability for 2020 is $277 million, of which $271 million and was accrued as of January 1, 2020 and an additional $6 million was accrued in the second quarter, with a corresponding deferred expense asset that will be amortized to expense through December 31, 2020, on a straight-line basis. We settled the 2020 HIF liability in September 2020. The HIF is not deductible for income tax purposes, and is payable by September 30, 2020.purposes. Due to the reinstatement of the HIF in 2020, our effective tax rate is higher in 2020 compared with 2019.
Within ourUnder the Medicaid program, we must secure additional reimbursement from our state partners for this added cost. We have obtained a contractual commitmentscommitment or are receiving payments from all states in which we operate Medicaid programs to reimburse us for the HIF, and such HIF revenue is being recognized ratably throughout the year.
Income Taxes
The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, nondeductible expenses such as the HIF, certain compensation, and other general and administrative expenses.
The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers.
Recent Accounting Pronouncements Adopted
Credit Losses. In June 2016, the FASBFinancial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which was subsequently modified by several ASUs issued in 2018 and 2019. We adopted Topic 326 effective January 1, 2020,

using the modified retrospective approach. Under this method we recognized the cumulative effect of adopting the standard as an adjustment to the opening balance of retained earnings on January 1, 2020, which was immaterial.
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Recent Accounting Pronouncements Not Yet Adopted
Reference Rate Reform. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying generally accepted accounting principles to contracts, hedging relationships, and other transactions affected by a change in the reference rate from LIBORthe London Interbank Offered Rate (“LIBOR”) or another reference rate expected to be discontinued, if certain conditions are met. ASU 2020-04 is effective immediately and expires after December 31, 2022. We are evaluating the effect of reference rate reform and this guidance on our contracts and other transactions.
Other recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements.


3. Net Income per Share
The following table sets forth the calculation of net income per share:
Three Months Ended September 30,Nine Months Ended September 30,
 Three Months Ended March 31, 2020201920202019
 2020 2019
(In millions, except net income per share) (In millions, except net income per share)
Numerator:    Numerator:
Net income $178
 $198
Net income$185 $175 $639 $569 
Denominator:    Denominator:
Shares outstanding at the beginning of the period 61.9
 62.1
Shares outstanding at the beginning of the period58.7 62.2 61.9 62.1 
Weighted-average number of shares issued:    Weighted-average number of shares issued:
Stock purchases (1.7) 
Stock purchases(2.8)
Stock-based compensation 
 
Stock-based compensation0.1 0.1 
Denominator for basic net income per share 60.2
 62.1
Denominator for basic net income per share58.7 62.2 59.2 62.2 
Effect of dilutive securities: (1)
    
Effect of dilutive securities: (1)
Warrants 0.1
 3.5
Warrants0.8 1.8 
Stock-based compensation 0.7
 0.6
Stock-based compensation0.9 0.6 0.8 0.6 
Denominator for diluted net income per share 61.0
 66.2
Denominator for diluted net income per share59.6 63.6 60.0 64.6 
    
Net income per share - Basic (2)
 $2.95
 $3.19
Net income per share - Basic (2)
$3.14 $2.81 $10.80 $9.15 
Net income per share - Diluted (2)
 $2.92
 $2.99
Net income per share - Diluted (2)
$3.10 $2.75 $10.65 $8.80 

(1)    The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. All warrants outstanding as of December 31, 2019, were settled in the first quarter of 2020. For more information refer to Note 9, “Stockholders' Equity.”
(2)    Source data for calculations in thousands.
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(1)The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. Approximately 0.1 million anti-dilutive shares were not included in the computation of diluted net income per share for the three months ended March 31, 2019. All warrants outstanding as of December 31, 2019, were settled in the first quarter of 2020. For more information refer to Note 8, “Stockholders' Equity.”
(2)Source data for calculations in thousands.
4. Business Combinations
In the third quarter of 2020, we closed on 2 business combinations in the Health Plans segment, consistent with our strategy to grow in our existing markets and expand into new markets. For both transactions, we applied the acquisition method of accounting, where the total purchase price was allocated, or preliminarily allocated, to the tangible and intangible assets acquired and liabilities assumed, based on their fair values as of the acquisition dates. We expect to complete the final determination of the purchase price allocations as soon as practicable, but no later than one year following the closing date in accordance with Accounting Standards Codification Topic 805, Business Combinations. The table below illustrates the intangible assets acquired, by major class, for the 2 acquisitions. Acquisition-related costs were insignificant.
New York. On July 1, 2020, we closed on the acquisition of certain assets of YourCare Health Plan, Inc., a Medicaid health plan, for a cash purchase price of $42 million. In connection with this transaction, we added approximately 47,000 Medicaid members in New York. We recorded goodwill of $31 million for this transaction, which is deductible for income tax purposes. The goodwill recorded relates to future economic benefits arising from expected synergies to be achieved, including the use of our existing infrastructure to support the added membership.
Kentucky. On September 1, 2020, we closed on the acquisition of certain assets of Passport Health Plan, Inc., a Medicaid health plan. Effective on that same date, the Kentucky Medicaid agency approved the novation of Passport’s Medicaid contract to Molina Healthcare of Kentucky, Inc. As a result, we added approximately 325,000 Medicaid members in Kentucky. As of September 30, 2020, the purchase price allocation was preliminary due to the proximity of the acquisition date to September 30, 2020, and the time and level of effort required to develop fair value measurements for the assets acquired and liabilities assumed.
The estimated total purchase price of $60 million includes our initial cash payment of $20 million in September 2020, plus estimated contingent consideration which consists primarily of an amount due to the seller for members we enroll in the open enrollment period for the 2021 plan year, over a minimum threshold, which resulted in an initial contingent consideration liability of $40 million. We expect to settle this liability in the first quarter of 2021. Contingent consideration liabilities are remeasured to fair value at each quarter until the contingencies are resolved with fair value adjustments, if any, recorded to operations. See further information in Note 5, “Fair Value Measurements.” We recorded goodwill of $27 million for this transaction, which is deductible for income tax purposes. The goodwill recorded relates to future economic benefits arising from the assembled workforce, and the future growth associated with the member contract rights that are incremental to the contract rights identified.
The following table presents the intangible assets identified in the transactions described above. The weighted-average amortization period for the identified intangible assets, in the aggregate, is 10.7 years.
Fair ValueLife
 (In millions)(Years)
Intangible asset by type:
Contract rights - member list$24 5-10
Trade name15 16
Provider network10
$47 

4. 5. Fair Value Measurements
We generally consider the carrying amounts of current assets and current liabilities (not including the current portion of long-term debt) to approximate their fair values because of the relatively short period of time between the origination of these instruments and their expected realization or payment. For our financial instruments measured at fair value on a recurring basis, we prioritize the inputs used in measuring fair value according to the three-tier fair value hierarchy. For a description of the methods and assumptions that we use to a) estimate the fair value; and b) determine the

classification according to the fair value hierarchy for each financial instrument, refer to our 2019 Annual Report on Form 10-K, Note 4, Fair“Fair Value MeasurementsMeasurements.”
As of September 30, 2020, our Level 3 financial instruments recorded at fair value on a recurring basis included contingent consideration liabilities of $40 million, in connection with the Kentucky acquisition described in Note 4, “Business Combinations.” Such liabilities are reported in “Accounts payable, accrued liabilities and other” in the accompanying consolidated balance sheets. The fair value of the contingent consideration was estimated using a
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simulation-based option pricing model through the end of the measurement period of approximately 5 months, and included certain non-observable inputs. The key assumptions included a U.S. Treasury based risk-free rate of return, expected asset volatility of 35%, expected revenue volatility of 9%, forecasted membership enrollment, and other estimated revenue, asset and payment correlations and discount rates. The model produced an estimated range of undiscounted amounts Molina could pay under the contingent consideration arrangement of $25 million to $75 million.
Our financial instruments measured at fair value on a recurring basis at March 31,September 30, 2020, were as follows:
 Total Observable Inputs (Level 1) Directly or Indirectly Observable Inputs (Level 2) Unobservable Inputs (Level 3)
 (In millions)
Corporate debt securities$1,260
 $
 $1,260
 $
Mortgage-backed securities451
 
 451
 
Asset-backed securities143
 
 143
 
Municipal securities138
 
 138
 
Certificates of deposit7
 
 7
 
Government-sponsored enterprise securities (“GSEs”)6
 
 6
 
U.S. Treasury notes5
 
 5
 
Total assets$2,010
 $
 $2,010
 $
Observable InputsDirectly or Indirectly Observable InputsUnobservable Inputs
Total(Level 1) (Level 2) (Level 3)
 (In millions)
Corporate debt securities$1,041 $$1,041 $
Mortgage-backed securities417 417 
Municipal securities168 168 
Asset-backed securities136 136 
Certificates of deposit
U.S. Treasury notes
Total assets$1,769 $$1,769 $
Contingent consideration liabilities$40 $$$40 
Total liabilities$40 $$$40 
Our financial instruments measured at fair value on a recurring basis at December 31, 2019, were as follows:
 Total Observable Inputs (Level 1) Directly or Indirectly Observable Inputs (Level 2) Unobservable Inputs (Level 3)
 (In millions)
Corporate debt securities$1,178
 $
 $1,178
 $
Mortgage-backed securities420
 
 420
 
Asset-backed securities127
 
 127
 
Municipal securities78
 
 78
 
Certificates of deposit1
 
 1
 
GSEs49
 
 49
 
U.S. Treasury notes86
 
 86
 
Foreign securities7
 
 7
 
Subtotal1,946
 
 1,946
 
Call option derivative asset29
 
 
 29
Total assets$1,975
 $
 $1,946
 $29
        
Conversion option derivative liability$29
 $
 $
 $29
Total liabilities$29
 $
 $
 $29

Observable InputsDirectly or Indirectly Observable InputsUnobservable Inputs
Total(Level 1)(Level 2)(Level 3)
 (In millions)
Corporate debt securities$1,178 $$1,178 $
Mortgage-backed securities420 420 
Municipal securities78 78 
Asset-backed securities127 127 
Certificates of deposit
U.S. Treasury notes86 86 
GSEs49 49 
Other
Subtotal1,946 1,946 
Call option derivative asset29 29 
Total assets$1,975 $$1,946 $29 
Conversion option derivative liability$29 $$$29 
Total liabilities$29 $$$29 
The net changes in fair value of Level 3 financial instruments were insignificant to our results of operations for the threenine months ended March 31,September 30, 2020.

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Derivatives
The following table summarizes the fair values and the presentation of our derivative financial instruments in the accompanying consolidated balance sheets:
 Balance Sheet Location March 31,
2020
 December 31,
2019
   (In millions)
Derivative asset:     
Call optionCurrent assets: Prepaid expenses and other current assets $
 $29
Derivative liability:     
Conversion optionCurrent liabilities: Accounts payable, accrued liabilities and other $
 $29

Balance Sheet LocationSeptember 30,
2020
December 31,
2019
 (In millions)
Derivative asset:
Call optionCurrent assets: Prepaid expenses and other current assets$$29 
Derivative liability:
Conversion optionCurrent liabilities: Accounts payable, accrued liabilities and other$$29 
For additional description ofinformation regarding our derivative financial instruments, see Note 11, “Debt,” and Note 12, “Derivatives,” in our 2019 Annual Report on Form 10-K. Our derivative financial instruments did not qualify for hedge treatment; therefore, the change in fair value of these instruments is recognized immediately in our consolidated statements of income, and reported in “Other income, net.” Gains and losses for our derivative financial instruments are presented individually in the accompanying consolidated statements of cash flows, “Supplemental cash flow information.”
In the first quarter of 2020, we received $27 million for the settlement of the call option derivative asset, and we paid $39 million to settle the outstanding $12 million principal amount of the 1.125% Convertible Notes, and settle the related conversion option. For more information, refer to Notes 7, “Debt,8, “Debt,” and 8, “Stockholders' Equity.9, “Stockholders' Equity.
Fair Value Measurements – Disclosure Only
The carrying amounts and estimated fair values of our notes payable are classified as Level 2 financial instruments. Fair value for these securities is determined using a market approach based on quoted market prices for similar securities in active markets or quoted prices for identical securities in inactive markets. The carrying amount and estimated fair value of the Term Loan Facility is classified as a Level 3 financial instrument, because certain inputs used
 September 30, 2020December 31, 2019
Carrying
Amount
Fair ValueCarrying
Amount
Fair Value
 (In millions)
4.375% Notes$789 $816 $$
5.375% Notes697 731 696 745 
4.875% Notes327 337 327 340 
Term loan facility (1)
220 220 
1.125% Convertible Notes (1)
12 42 
Total$1,813 $1,884 $1,255 $1,347 
______________________
(1)For more information on financing activities, refer to determine its fair value are not observable. As of March 31, 2020, the carrying amount of the Term Loan Facility approximated fair value because its interest rate is a variable rate that approximates rates currently available to us.Note 8, “Debt.”
 March 31, 2020 December 31, 2019
 
Carrying
Amount
 

Fair Value
 
Carrying
Amount
 

Fair Value
 (In millions)
5.375% Notes$696
 $701
 $696
 $745
4.875% Notes326
 310
 327
 340
Term Loan Facility600
 600
 220
 220
1.125% Convertible Notes (1)

 
 12
 42
Totals$1,622
 $1,611
 $1,255
 $1,347

______________________
(1)For more information on debt repayments, refer to Note 7, “Debt.”


5. 6. Investments
Available-for-Sale Investments
We consider all our investments classified as current assets to be available-for-sale. The following tables summarize our investments as of the dates indicated:
September 30, 2020
March 31, 2020Amortized CostGross UnrealizedEstimated Fair Value
Amortized 
Gross
Unrealized
 
Estimated
Fair
GainsLosses
Cost Gains Losses Value
(In millions) (In millions)
Corporate debt securities$1,277
 $4
 $21
 $1,260
Corporate debt securities$1,007 $35 $$1,041 
Mortgage-backed securities453
 6
 8
 451
Mortgage-backed securities408 10 417 
Municipal securitiesMunicipal securities166 168 
Asset-backed securities144
 
 1
 143
Asset-backed securities133 136 
Municipal securities138
 
 
 138
Certificates of deposit7
 
 
 7
Certificates of deposit
GSEs6
 
 
 6
U.S. Treasury notes5
 
 
 5
U.S. Treasury notes
Totals$2,030
 $10
 $30
 $2,010
TotalTotal$1,721 $50 $$1,769 

 December 31, 2019
 Amortized 
Gross
Unrealized
 
Estimated
Fair
 Cost Gains Losses Value
 (In millions)
Corporate debt securities$1,174
 $5
 $1
 $1,178
Mortgage-backed securities420
 1
 1
 420
Asset-backed securities126
 1
 
 127
Municipal securities78
 
 
 78
Certificates of deposit1
 
 
 1
GSEs49
 
 
 49
U.S. Treasury notes86
 
 
 86
Foreign securities7
 
 
 7
Totals$1,941
 $7
 $2
 $1,946
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 December 31, 2019
 Amortized CostGross UnrealizedEstimated Fair Value
 GainsLosses
 (In millions)
Corporate debt securities$1,174 $$$1,178 
Mortgage-backed securities420 420 
Municipal securities78 78 
Asset-backed securities126 127 
Certificates of deposit
U.S. Treasury notes86 86 
GSEs49 49 
Other
Total$1,941 $$$1,946 
The contractual maturities of our available-for-sale investments as of March 31,September 30, 2020 are summarized below:
 Amortized Cost 
Estimated
Fair Value
 (In millions)
Due in one year or less$375
 $375
Due after one year through five years1,032
 1,017
Due after five years through ten years183
 181
Due after ten years440
 437
Totals$2,030
 $2,010

Amortized CostEstimated
Fair Value
 (In millions)
Due in one year or less$193 $195 
Due after one year through five years943 975 
Due after five years through ten years160 165 
Due after ten years425 434 
Total$1,721 $1,769 
Gross realized gains and losses from sales of available-for-sale securities are calculated under the specific identification method and are included in investment income. Gross realized investment gains amounted to $5 million inwere insignificant for the three months ended March 31,September 30, 2020, and amounted to $6 million for the nine months ended September 30, 2020. Gross realized investment gains amounted to $11 million for the three and nine months ended September 30, 2019. Gross realized investment losses were insignificant infor the three and nine months ended March 31, 2020. Gross realized investment gainsSeptember 30, 2020, and losses were insignificant in the three months ended March 31, 2019.
We have determined that unrealized losses at March 31,September 30, 2020, and December 31, 2019, have primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we have determined that an allowance for credit losses iswas not necessary. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience losses. In the event that we dispose of these securities before maturity, we expect that realized losses, if any, will be insignificant. 

The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months as of September 30, 2020 and those that have beenDecember 31, 2019:
 September 30, 2020December 31, 2019
 Estimated
Fair
Value
Unrealized
Losses
Total
Number of
Positions
Estimated
Fair
Value
Unrealized
Losses
Total
Number of
Positions
 (Dollars in millions)
Corporate debt securities$35 $18 $222 $167 
Mortgage-backed securities104 143 72 
Total$139 $25 $365 $239 
None of our available-for-sale investments were in a continuous loss position for 12 months or more as of March 31, 2020:
 
In a Continuous Loss Position
for Less than 12 Months
 
In a Continuous Loss Position
for 12 Months or More
 
Estimated
Fair
Value
 
Unrealized
Losses
 
Total
Number of
Positions
 
Estimated
Fair
Value
 
Unrealized
Losses
 
Total
Number of
Positions
 (Dollars in millions)
Corporate debt securities$805
 $21
 627
 $
 $
 
Mortgage-backed securities211
 8
 128
 
 
 
Asset-backed securities90
 1
 70
 
 
 
Totals$1,106
 $30
 825
 $
 $
 
The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 monthsSeptember 30, 2020, or more as of December 31, 2019:2019.
 
In a Continuous Loss Position
for Less than 12 Months
 
In a Continuous Loss Position
for 12 Months or More
 
Estimated
Fair
Value
 
Unrealized
Losses
 
Total
Number of
Positions
 
Estimated
Fair
Value
 
Unrealized
Losses
 
Total
Number of
Positions
 (Dollars in millions)
Corporate debt securities$222
 $1
 167
 $
 $
 
Mortgage-backed securities143
 1
 72
 
 
 
Totals$365
 $2
 239
 $
 $
 

Held-to-Maturity Investments
Pursuant to the regulations governing our Health Plans segment subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, and U.S. Treasury securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. The use of these funds is limited as required by regulations in the various states in which we operate, or as needed in the event
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of insolvency of capitated providers. Therefore, such investments are reported as “Restricted investments” in the accompanying consolidated balance sheets.
We have the ability to hold these restricted investments until maturity, and as a result, we would not expect the value of these investments to decline significantly due to a sudden change in market interest rates. Our held-to-maturity restricted investments are carried at amortized cost, which approximates fair value. Such investments amounted to $82$93 million at March 31,September 30, 2020, of which $79$91 million will mature in one year or less, and $3$2 million will mature in after one through five years.

6.7. Medical Claims and Benefits Payable
The following table provides the details of our medical claims and benefits payable as of the dates indicated.indicated:
 March 31,
2020
 December 31,
2019
 (In millions)
Fee-for-service claims incurred but not paid (“IBNP”)$1,444
 $1,406
Pharmacy payable150
 126
Capitation payable62
 55
Other325
 267
 $1,981
 $1,854

September 30,
2020
December 31,
2019
 (In millions)
Fee-for-service claims incurred but not paid (“IBNP”)$1,615 $1,406 
Pharmacy payable148 126 
Capitation payable73 55 
Other453 267 
Total$2,289 $1,854 
“Other” medical claims and benefits payable includes amounts payable to certain providers for which we act as an intermediary on behalf of various government agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Non-risk provider payables amounted to $116$168 million and $132 million as of March 31,September 30, 2020, and December 31, 2019, respectively.

The following table presents the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior periods”years” represent the amounts by which our original estimateestimates of medical claims and benefits payable at the beginning of the periodyear were more than the actual amount of the liability,liabilities, based on information (principally the payment of claims) developed since that liability wasthose liabilities were first reported.
 Three Months Ended March 31,
 2020 2019
 (In millions)
Medical claims and benefits payable, beginning balance$1,854
 $1,961
Components of medical care costs related to:   
Current period3,817
 3,560
Prior periods(101) (189)
Total medical care costs3,716
 3,371
Change in non-risk and other provider payables(10) 171
Payments for medical care costs related to:   
Current period2,274
 2,197
Prior periods1,305
 1,311
Total paid3,579
 3,508
Medical claims and benefits payable, ending balance$1,981
 $1,995

Nine Months Ended September 30,
20202019
 (In millions)
Medical claims and benefits payable, beginning balance$1,854 $1,961 
Components of medical care costs related to:
Current year11,478 10,613 
Prior years(66)(253)
Total medical care costs11,412 10,360 
Change in non-risk and other provider payables50 131 
Payments for medical care costs related to:
Current year9,500 8,996 
Prior years1,527 1,481 
Total paid11,027 10,477 
Medical claims and benefits payable, ending balance$2,289 $1,975 
Our estimates of medical claims and benefits payable recorded at December 31, 2019, and 2018 developed favorably by approximately $101$66 million and $189$253 million as of March 31,September 30, 2020, and 2019, respectively.
The favorableIn the nine months ended September 30, 2020, medical care costs related to the prior year development recognizedreflect the release of additional reserves for moderately adverse conditions included in the three months ended March 31, 2020, was primarily due to lowerour prior year estimates, partially offset by higher than expected utilization of medical services bycosts for settling certain claims with certain providers. The differences between our Medicaid members,original estimates for such claims in 2019, and improved operating performance. Consequently, the ultimate costs recognized in 2020, were not discernible until additional information was provided to us in 2020 and the effect became clearer over time as claimsclaim payments were processed, were lower thanprocessed. The release of
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additional reserves for moderately adverse conditions included in our originalprior year estimates was substantially offset by the replenishment of the reserve recorded in 2019.

medical care costs related to the current year.
7. Debt
8. Debt
All our debt is held at the parent, which is reported in the Other segment. The following table summarizes our outstanding debt obligations and their classification in the accompanying consolidated balance sheets:
September 30,
2020
December 31,
2019
(In millions)
Current portion of long-term debt: (1)
Term loan facility$$
1.125% Convertible Notes, net of unamortized discount12 
Total$$18 
Non-current portion of long-term debt:
4.375% Notes due 2028$800 $
5.375% Notes due 2022700 700 
4.875% Notes due 2025330 330 
Term loan facility214 
Deferred debt issuance costs(17)(7)
Total$1,813 $1,237 
______________________
(1)
 March 31,
2020
 December 31,
2019
 (In millions)
Current portion of long-term debt:   
Term Loan Facility$26
 $6
1.125% Convertible Notes, net of unamortized discount
 12
Total$26
 $18
Non-current portion of long-term debt:   
5.375% Notes due 2022$700
 $700
4.875% Notes due 2025330
 330
Term Loan Facility574
 214
Debt issuance costs(8) (7)
Total$1,596
 $1,237

Reported in “Accounts payable, accrued liabilities and other.”
Credit Agreement
We are party toIn June 2020, we entered into a credit agreement (the “Credit Agreement”) that replaced our prior credit agreement. The terms of the Credit Agreement which provides for an unsecured delayed draw term loan facility (the “Term Loan Facility”), and an unsecuredare substantially similar to the terms of the prior agreement. Among various provisions, significant changes incorporated to the Credit Agreement included:
An increase of the revolving credit facility (the “Credit Facility”), both from $500 million to $1.0 billion;
A $15 million swingline sub-facility and a $100 million letter of credit sub-facility;
An increase of incremental term loans available to finance certain acquisitions from $150 million to $500 million, plus an unlimited amount as long as our consolidated net leverage ratio is not greater than 3:1;
The ability to engage in acquisitions where the consummation of such acquisitions is not conditioned on the availability of, or on obtaining, third-party financing;
Termination of the term loan facility under the prior credit agreement, which was repaid as described in further detail below.below; and
LIBOR succession provisions.
The Credit Agreement has a term of five years, and all amounts outstanding will be due and payable on June 8, 2025. Borrowings under the Credit Agreement bear interest based, at our election, on a base rate or other defined rate, plus in each case, the applicable margin. In addition to interest payable on the principal amount of

indebtedness outstanding from time to time under the Credit Agreement, we are required to pay a quarterly commitment fee.
The Credit Agreement contains customary non-financial and financial covenants. As of March 31,September 30, 2020, we were in compliance with all financial and non-financial covenants under the Credit Agreement and other long-term debt.
Term Loan Facility. In March 2020, we drew down the Term Loan Facility’s remaining available capacity of $380 million, for an outstanding balance of $600 million as of March 31, 2020. The Term Loan Facility amortizes in quarterly installments, commencing on September 30, 2020, equal to the principal amount of the Term Loan Facility outstanding multiplied by rates ranging from 1.25% to 2.50% (depending on the applicable fiscal quarter) for each fiscal quarter. Because each advance under the Term Loan Facility results in a permanent reduction to its borrowing capacity, no further advances are available. Any remaining outstanding balance under the Term Loan Facility will be due and payable on its January 31, 2024 expiration date.
Credit Facility. Our Credit Facility provides for borrowings up to $500 million, and expires on January 31, 2022; therefore, any amounts outstanding will be due and payable on that date. As of March 31,September 30, 2020, 0 amounts were outstanding under the Credit Facility,Facility.
In the nine months ended September 30, 2020, we recognized losses on debt repayment of $5 million in connection with repayment of our term loan facility and outstanding lettersother financing transactions. In the third quarter and nine months ended September 30, 2019, we recognized a loss on debt repayment of credit amounting$2 million and a gain on debt repayment of $15 million, respectively, in connection with convertible senior notes repayment transactions.
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High-Yield Senior Notes
Our high-yield senior notes are described below. Each of these notes are senior unsecured obligations of Molina and rank equally in right of payment with all existing and future senior debt, and senior to $1all existing and future subordinated debt of Molina. In addition, each of the notes contain customary non-financial covenants and change of control provisions.
The indentures governing the high-yield senior notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the applicable indenture.
4.375% Notes due 2028.On June 2, 2020, we completed the private offering of $800 million reduced our borrowing capacityaggregate principal amount of senior notes (the “4.375% Notes”) due June 15, 2028, unless earlier redeemed. The 4.375% Notes contain optional early redemption provisions, with redemption prices in excess of par. Interest, at a rate of 4.375% per annum, is payable semiannually in arrears on June 15 and December 15 of each year, commencing December 15, 2020. A portion of the net proceeds from the 4.375% Notes offering was used to repay $600 million principal amount outstanding under the Credit Facilityterm loan facility of our prior credit agreement, and the balance is intended to $499be used for general corporate purposes. Deferred issuance costs amounted to $11 million.
5.375% Notes due 2022
2022.We had $700 million aggregate principal amount of senior notes (the “5.375% Notes”) outstanding as of March 31,September 30, 2020, which are due November 15, 2022, unless earlier redeemed. Interest, at a rate of 5.375% per annum, is payable semiannually in arrears on May 15 and November 15. The 5.375% Notes contain customary non-financial covenants and change in control provisions.
4.875% Notes due 2025
2025. We had $330 million aggregate principal amount of senior notes (the “4.875% Notes”) outstanding as of March 31,September 30, 2020, which are due June 15, 2025, unless earlier redeemed. Interest, at a rate of 4.875% per annum, is payable semiannually in arrears on June 15 and December 15. The 4.875% Notes contain customary non-financial covenants and change of control provisions.
1.125% Cash Convertible Senior Notes due 2020
For a description of the 1.125% cash convertible senior notes due January 15, 2020 (the “1.125% Convertible Notes”), see Note 11, “Debt,” in our 2019 Annual Report on Form 10-K. In January 2020, we paid $39 million to settle the outstanding $12 million principal amount of the 1.125% Convertible Notes, and settle the related conversion option.

Cross-Default Provisions
The indentures governing the 4.875% Notes and the 5.375% Notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the applicable indenture.

8. 9. Stockholders' Equity
Stock Purchase ProgramPrograms
In earlySeptember 2020, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This program will be funded with cash on hand and extends through December 31, 2021. The exact timing and amount of any repurchase will be determined by management based on market conditions and share price, in addition to other factors, and subject to the restrictions relating to volume, price, and timing under applicable law. No shares were purchased under this program through October 29, 2020.
In December 2019, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This program was funded bywith existing cash on hand and was completed in March 2020.
Under this program, pursuant to a Rule 10b5-1 trading plans,plan, we purchased approximately 3.4 million shares of our common stock for $446 million in the first quarter of 2020 (average cost of $132.45 per share). In the first quarter of 2020, we also paid $7 million to settle shares purchased in late December 2019.
1.125% Warrants
For a description of the 1.125% Warrants, refer to our 2019 Annual Report on Form 10-K, Note 12, “Derivatives,” and Note 14, “Stockholders’ Equity.” Approximately 310,000 of the 1.125% Warrants were outstanding at December 31, 2019. In the first quarter of 2020, we entered into privately negotiated termination agreements under which we paid $30 million to the Counterpartiescounterparties for the termination of the remaining 1.125% Warrants outstanding, which resulted in a reduction of additional paid-in-capital for the same amount.

Share-Based Compensation
In connection with our employee stock plans, approximately 98,000192,000 shares of common stock vested or were purchased, net of shares used to settle employees’ income tax obligations, during the threenine months ended March 31,September 30, 2020.
Share-based compensation is recorded to “General and administrative expenses” in the accompanying consolidated statements of income. Total share-based compensation expense amounted to $12$15 million and $9 $10
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million, respectively, in the threethird quarter of 2020 and 2019. Total share-based compensation expense amounted to $43 million and $29 million, respectively, in the nine months ended March 31,September 30, 2020 and 2019.
As of March 31,September 30, 2020, there was $89approximately $76 million of total unrecognized compensation expense related to unvested restricted stock awards (“RSAs”), and performance stock units (“PSUs”), which we expect to recognize over remaining weighted-average periods of 2.92.4 years and 1.91.5 years, respectively. This unrecognized compensation cost assumes an estimated forfeiture rate of 10.7%11.5% for non-executive employees as of March 31,September 30, 2020.
As of March 31,September 30, 2020, thereunrecognized stock option expense was also $3 million of total unrecognized compensation expense related to unvested stock options, which we expect to recognize over a weighted-average period of 0.5 years.insignificant. NaN stock options were granted or exercised in the threenine months ended March 31,September 30, 2020.
Activity for RSAs and PSUs is summarized below:
RSAsWeighted
Average
Grant Date
Fair Value
PSUsWeighted
Average
Grant Date
Fair Value
Unvested balance, December 31, 2019447,680 $102.41 324,078 $101.45 
Granted334,233 125.99 187,028 123.09 
Vested(166,115)96.19 (7,368)68.16 
Forfeited(26,439)114.48 (29,271)98.72 
Unvested balance, September 30, 2020589,359 $116.99 474,467 $110.67 
 RSAs PSUs Total 
Weighted
Average
Grant Date
Fair Value
Unvested balance, December 31, 2019447,680
 324,078
 771,758
 $102.01
Granted294,319
 160,929
 455,248
 122.20
Vested(151,110) (7,368) (158,478) 92.92
Forfeited(12,202) (22,826) (35,028) 101.60
Unvested balance, March 31, 2020578,687
 454,813
 1,033,500
 $112.31

The aggregate fair values of RSAs and PSUs granted and vested are presented in the following table:
Nine Months Ended September 30,
20202019
(In millions)
Granted:
RSAs$42 $32 
PSUs23 19 
Total granted$65 $51 
Vested:
RSAs$21 $18 
PSUs
Total vested$22 $20 
 Three Months Ended March 31,
 2020 2019
 (In millions)
Granted:   
RSAs$36
 $30
PSUs19
 18
Total granted$55
 $48
Vested:   
RSAs$19
 $16
PSUs1
 2
Total vested$20
 $18


9. 10. Segments
We currently have 2 reportable segments: the Health Plans segment and the Other segment. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.
Margin is the appropriate earnings measure for our reportable segments, based on how our chief operating decision maker currently reviews results, assesses performance, and allocates resources.
The key metrics used to assess the performance of our Health Plans segment are premium revenue, medical margin and MCR. MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying margin, or the amount earned by the Health Plans segment after medical costs are deducted from premium revenue, is the most important measure of earnings reviewed by management. Margin for our Health Plans segment is referred to as “Medical Margin.”

The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented.
 Three Months Ended March 31,
 2020 2019
 (In millions)
Total revenue:   
Health Plans$4,545
 $4,117
Other4
 2
Consolidated$4,549
 $4,119
Molina Healthcare, Inc. September 30, 2020 Form 10-Q | 22


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Three Months Ended September 30,Nine Months Ended September 30,
2020201920202019
(In millions)
Total revenue:
Health Plans$5,020 $4,239 $14,181 $12,546 
Other
Consolidated$5,021 $4,243 $14,188 $12,555 
The following table reconciles margin to consolidated income before income taxes:
Three Months Ended September 30,Nine Months Ended September 30,
Three Months Ended March 31,2020201920202019
2020 2019
(In millions)(In millions)
Margin:   Margin:
Health Plans$588
 $581
Health Plans$670 $561 $2,032 $1,725 
Add: other operating revenues (1)
245
 167
Add: other operating revenues (1)
253 159 744 470 
Less: other operating expenses (2)
(559) (468)
Less: other operating expenses (2)
(634)(463)(1,789)(1,393)
Operating income274
 280
Operating income289 257 987 802 
Other expenses, net21
 20
Other expenses, net27 24 77 52 
Income before income tax expense$253
 $260
Income before income tax expense$262 $233 $910 $750 
______________________
(1)Other operating revenues include premium tax revenue, health insurer fees reimbursed, and investment income and other revenue.
(2)Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fees, depreciation and amortization, and other costs.
(1)Other operating revenues include premium tax revenue, health insurer fees reimbursed, and investment income and other revenue.
(2)Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fees, depreciation and amortization, and other costs.
10. 11. Commitments and Contingencies
COVID-19 Pandemic
On March 11, 2020,We continue to monitor and assess the World Health Organization officially declaredestimated operating and financial impact of the COVID-19 pandemic, and as it evolves, we continue to process, assemble, and assess member utilization information. We believe that our cash resources, borrowing capacity available under the disease caused byCredit Agreement, and cash flow generated from operations will be sufficient to withstand the novel coronavirus, a pandemic. The ultimate effectsfinancial impact of the pandemic, and will enable us to continue to support our operations, regulatory requirements, debt repayment obligations, and capital expenditures for the duration of any such effects, including any impact to our medical care ratio (which could increase or decrease), are not known or quantifiable at this time. As of March 31, 2020, we have not experienced any significant interruptions in the services we provide, nor was there a material impact of the pandemic to our consolidated financial position, results of operations, and cash flows in the first quarter of 2020.foreseeable future.
Legal Proceedings
The healthcare industry is subject to numerous laws and regulations of federal, state, and local governments. Penalties associated with violations of these laws and regulations include significant fines, exclusion from participating in publicly funded programs, and the repayment of previously collected revenues.
In the ordinary course of business we are involved in legal actions, some of which seek monetary damages which are not covered by insurance. We have accrued liabilities for certain matters for which we deem the loss to be both probable and reasonably estimable, but the outcome of legal actions is inherently uncertain and our estimates of such losses could be understated, and could also subsequently change as a result of further developments of these matters. For certain pending matters, accruals have not been established because we believe we are not liable or because such matters have not progressed sufficiently through discovery or factual development to enable us to reasonably estimate a range of possible loss. An adverse determination in one or more of these pending matters could have an adverse effect on our consolidated financial position, results of operations, or cash flows.


11.Subsequent Events
Acquisition of Magellan Complete Care
On April
Molina Healthcare, Inc. September 30, 2020 we entered into a definitive agreement to acquire the Magellan Complete Care (“MCC”) lineForm 10-Q | 23

Table of business of Magellan Health, Inc. The purchase price for the transaction is approximately $820 million, net of certain tax benefits, which we intend to fund with cash on hand.Contents
MCC is a managed care organization serving members in 6 states, including Medicaid members in Arizona and statewide in Virginia. Through its Senior Whole Health branded plans, MCC provides fully integrated plans for Medicaid and Medicare dual beneficiaries in Massachusetts, as well as Managed Long Term Care (“MLTC,” commonly known nationally as “MLTSS”) in New York. As of December 31, 2019, MCC served approximately 155,000 members, with full year 2019 revenues greater than $2.7 billion.
The transaction is subject to federal and state regulatory approvals, and other customary closing conditions, and is expected to close in the first quarter of 2021. In connection with this transaction, Magellan Health, Inc. has agreed to provide certain transition services following the closing.
In connection with the MCC acquisition, we entered into a commitment letter on April 30, 2020, pursuant to which, among other things, the lenders have committed to provide us with debt financing in the aggregate principal amount of up to $400 million.
Marketplace Risk Corridor Ruling
On April 27, 2020, the United States Supreme Court issued its opinion in Maine Community Health Options v. United States. The Supreme Court held that §1342 of the Affordable Care Act obligated the federal government to pay participating insurers the full Marketplace risk corridor amounts calculated by that statute, that such payment obligations survived Congress’ appropriations riders, and that impacted insurers may sue the federal government in the U.S. Court of Federal Claims to recover damages for breach of that obligation. There are no distinguishing factors regarding liability or damages between this case and the cases we ourselves have brought against the federal government for its failure to pay our Marketplace risk corridors claims for 2014, 2015, and 2016. We have already obtained summary judgment for our 2014 and 2015 risk corridor claims in the approximate amount of $52 million, and we have brought another claim for approximately $76 million for the government’s failure to pay our 2016 risk corridor claims. The timing of recognition and collection of these outstanding Marketplace risk corridor claims is uncertain, but we will request that the Court of Claims act as expeditiously as possible to enter judgment for all of the risk corridors amounts owed to us. 


MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS (“MD&A”)
FORWARD-LOOKING STATEMENTS
This quarterly report on Form 10-Q contains forward-looking statements regarding our business, financial condition, and results of operations within the meaning of Section 27A of the Securities Act of 1933, or Securities Act, and Section 21E of the Securities Exchange Act of 1934, or Securities Exchange Act. Many of the forward-looking statements are located under the heading “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” Forward-looking statements provide current expectations of future events based on certain assumptions and include any statement that does not directly relate to any historical or current fact. Forward-looking statements can also be identified by words such as “guidance,” “future,” “anticipates,” “believes,” “estimates,” “expects,” “growth,” “intends,” “plans,” “predicts,” “projects,” “will,” “would,” “could,” “can,” “may,” and similar terms. Readers are cautioned not to place undue reliance on any forward-looking statements, as forward-looking statements are not guarantees of future performance and the Company’s actual results may differ significantly due to numerous known and unknown risks and uncertainties. Those known risks and uncertainties include, but are not limited to, the risk factors identified in the section ofsections titled “Risk Factors” in this Form 10-Q, our Annual Report on Form 10-K titled “Risk Factors,” as well asfor the year ended December 31, 2019, and our Quarterly Reports on Form 10-Q for the quarters ended March 31, 2020, and June 30, 2020, including without limitation the following:
the impact of the COVID-19 pandemic on our operations and financial results;
the numerous political, judicial, and market-based uncertainties associated with the Affordable Care Act (the “ACA”) or “Obamacare,” including the ultimate outcome of the Texas et al. v. U.S. et al. matter;matter now pending before the U.S. Supreme Court;
significant budget pressures on state governments from diminished tax revenues and their efforts to curtail current rates, to implement expected rate increases, or to maintain existing benefit packages or membership eligibility thresholds or criteria;
the market dynamics surrounding the ACA Marketplaces, including but not limited to uncertainties associated with the elasticity of demand for our products based on our pricing, risk adjustment requirements,estimates and results, the potential for disproportionate enrollment of higher acuity members, and the discontinuation of premium tax credits;
the uncertainties associated with the November 2020 Presidential and Congressional election;
subsequent adjustments to reported premium revenue based upon subsequent developments or new information, including changes to estimated amounts payable or receivable related to Marketplace risk adjustment;
the availability of adequate financing on acceptable terms to fund and capitalize our expansion and growth, repay our outstanding indebtedness at maturity, and meet our general liquidity needs;
our ability to consummate, integrate, and realize benefits from acquisitions, including the announced acquisitionacquisitions of Magellan Complete Care;Care and of Affinity;
the outcome of the protest and appeal proceedings in Kentucky with regard to the Medicaid contract award to our Kentucky health plan;
effective management of our medical costs;
our ability to predict with a reasonable degree of accuracy utilization rates, including utilization rates associated with the flu or coronavirus;
significant budget pressures on state governments from diminished tax revenues and their potential inability to maintain current rates, to implement expected rate increases, or to maintain existing benefit packages or membership eligibility thresholds or criteria;
the full reimbursement of the ACA health insurer fee, or HIF;
the success of our efforts to retain existing or awarded government contracts, and the success of any bid submissions in response to requests for proposal, including protest filings or defenses;our contracts in Ohio, California, Texas, and Kentucky;
the ability to manage our operations, including maintaining and creating adequate internal systems and controls relating to authorizations, approvals, provider payments, and the overall success of our care management initiatives;
our receipt of adequate premium rates to support increasing pharmacy costs, including costs associated with specialty drugs and costs resulting from formulary changes that allow the option of higher-priced non-generic drugs;
our ability to operate profitably in an environment where the trend in premium rate increases lags behind the trend in increasing medical costs;
the interpretation and implementation of federal or state medical cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions and requirements;
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our estimates of amounts owed for such cost expenditure floors, administrative cost and profit ceilings, premium stabilization programs, profit-sharing arrangements, and risk adjustment provisions;provisions and requirements;
the Medicaid expansion medical cost corridor, and any other retroactive adjustment to revenue where methodologies and procedures are subject to interpretation or dependent upon information about the health status of participants other than Molina members;

the interpretation and implementation of at-risk premium rules and state contract performance requirements regarding the achievement of certain quality measures, and our ability to recognize revenue amounts associated therewith;
cyber-attacks, ransomware attacks, or other privacy or data security incidents resulting in an inadvertent unauthorized disclosure of protected health information;
our expected exit from Puerto Rico, including the successful transfer of our members to alternative health plans, the effective run-out of claims, and the return of capital;
the success and renewal of our duals demonstration programs in California, Illinois, Michigan, Ohio, South Carolina, and Texas;
the accurate estimation of incurred but not reported or paid medical costs across our health plans;
efforts by states to recoup previously paid and recognized premium amounts;
complications, member confusion, eligibility re-determinations, or enrollment backlogs related to the renewal of Medicaid coverage, as well as the chilling effect of the new so-called public charge rule;
government audits, reviews, comment letters, or potential investigations, and any fine, sanction, enrollment freeze, monitoring program, or premium recovery that may result therefrom;
our expected exit from Puerto Rico, including the successful transfer of our members to alternative health plans, the effective run-out of claims, and the return of our capital;
changes with respect to our provider contracts and the loss of providers;
approval by state regulators of dividends and distributions by our health plan subsidiaries;
changes in funding under our contracts as a result of regulatory changes, programmatic adjustments, or other reforms;
high dollar claims related to catastrophic illness;
the favorable resolution of litigation, arbitration, or administrative proceedings, including litigation involving the ACA to which we are not a direct party;
the relatively small number of states in which we operate health plans, including the greater scale and revenues of our California, Ohio, Texas, and Washington health plans;
the failure to comply with the financial or other covenants in our credit agreementthe Credit Agreement or the indentures governing our outstanding notes;
the sufficiency of funds on hand to pay the amounts due upon maturity of our outstanding notes;
the failure of a state in which we operate to renew its federal Medicaid waiver;
changes generally affecting the managed care industry;
increases in government surcharges, taxes, and assessments;
the unexpected loss of the leadership of one or more of our senior executives; and
increasing competition and consolidation in the Medicaid industry.
Each of the terms “Molina Healthcare, Inc.” “Molina Healthcare,” “Company,” “we,” “our,” and “us,” as used herein, refers collectively to Molina Healthcare, Inc. and its wholly owned subsidiaries, unless otherwise stated. The Company assumes no obligation to revise or update any forward-looking statements for any reason, except as required by law.
Readers should refer to the section entitled “Risk Factors” in this Quarterly Report on Form 10-Q, in our Quarterly Reports on Form 10-Q for the quarters ended March 31, 2020, and June 30, 2020, and in our Annual Report on Form 10-K for the year ended December 31, 2019, for a discussion of certain risk factors that could materially affect our business, financial condition, cash flows, or results of operations. Given these risks and uncertainties, we can give no assurance that any results or events projected or contemplated by our forward-looking statements will in fact occur.
This Quarterly Report on Form 10-Q and the following discussion of our financial condition and results of operations should be read in conjunction with the accompanying consolidated financial statements and the notes to those statements appearing elsewhere in this report, and the audited financial statements and Management’s Discussion and Analysis appearing in our Annual Report on Form 10-K for the year ended December 31, 2019.


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OVERVIEW
Molina Healthcare, Inc., a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces (the “Marketplace”). Through our locally operated health plans in 1415 states and the Commonwealth of Puerto Rico, we served approximately 3.44.0 million members as of March 31,September 30, 2020. The health plans are generally operated by our respective wholly owned subsidiaries in those states each of which isand licensed as a health maintenance organizationorganizations (“HMO”).
FIRSTTHIRD QUARTER 2020 HIGHLIGHTS
We reported earningsnet income per diluted share of $2.92,$3.10 for the firstthird quarter of 2020, with net income of $178$185 million, and an after-tax marginwhich consisted of 3.9% percent.the following:
Premium revenue was $4.3 billion.of $4.8 billion, which increased 16.8% compared with the third quarter of 2019;
The consolidatedConsolidated medical care ratio (“MCR”) forof 85.9%, which decreased 40 basis points compared with 86.3% in the firstthird quarter of 2019;
General and administrative expense (“G&A”) ratio of 7.3%, which decreased 30 basis points compared with 7.6% in the third quarter of 2019; and
After-tax margin of 3.7%.
COVID Impacts
Unlike the second quarter of 2020, in which the combined COVID-related impacts temporarily increased to 86.3% compared with 85.3% in the first quarter of 2019, reflecting an increase in the Marketplace MCR.
Given the timing of the COVID-19 outbreak and related progression, the impact of COVID-19 on the MCR was limited in the quarter.
The prior period reserve development in the first quarter of 2020 was negligible. The first quarter of 2019 was positively impacted by approximately 140 basis points of favorable reserve development, primarily in the Medicaid line of business.
The general and administrative expense (“G&A”) ratio was 7.0%, which was lower than 2019 due to increased revenues. The current quarter also reflects incremental expense associated with the mobilization of our workforce to work at home and other new operational protocols related to COVID-19.
While net investment income during the quarter was on plan, the steep drop in interest rates will certainly impact future quarters.
The total company after-tax margin of 3.9% was in line with our expectations.
While earnings, in the firstthird quarter of 2020 metthe combination of COVID-related impacts netted to a negligible to slightly positive impact on earnings and included:
A modest net decrease in medical costs due primarily to COVID-related utilization curtailment;
Premium refunds to a number of our expectations,state Medicaid customers in response to the achievementCOVID-related utilization curtailment, which we experienced in both the second and third quarters of these results is noteworthy considering the expansive adaptations that we have made2020;
An increase in our workforceG&A spending on activities related to COVID; and operations
A meaningful increase to our Medicaid membership.
As we work through this unprecedented period of the COVID pandemic, we remain focused on executing on the underlying fundamentals of our business to continue to produce solid results, regardless of the short-term COVID-related impacts on our reported financial metrics and results.
Growth Initiatives
We made another major stride in the spanthird quarter of a few weeks due2020 related to the rapidly evolving COVID-19 pandemic,activation of our growth strategy. In September 2020, we signed a definitive agreement to purchase the net assets of Affinity Health Plan in New York for approximately $380 million, which we currently expect to close as early as the second quarter of 2021. We believe this purchase is another milestone in a growth-oriented 2020. Our growth initiatives continue to be anchored by our capital allocation priorities: first, organic growth of our core businesses; second, inorganic growth through accretive acquisitions; and our successful effortsthird, programmatically returning excess capital to avoid disruptions in the services we provide to our members and government customers.shareholders.


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FINANCIAL SUMMARY
Three Months Ended September 30,Nine Months Ended September 30,
Three Months Ended March 31, 2020201920202019
2020 2019
(Dollars in millions, except per-share amounts) (Dollars in millions, except per-share amounts)
Premium revenue$4,304
 $3,952
Premium revenue$4,768 $4,084 $13,444 $12,085 
Premium tax revenue150
 138
Premium tax revenue170 119 477 367 
Health insurer fees reimbursed66
 
Health insurer fees reimbursed69 — 206 — 
Investment income and other revenue29
 29
Investment income and other revenue14 40 61 103 
   
Medical care costs$3,716
 $3,371
Medical care costs$4,098 $3,523 $11,412 $10,360 
General and administrative expenses317
 302
General and administrative expenses368 323 1,030 953 
Premium tax expenses150
 138
Premium tax expenses170 119 477 367 
Health insurer fees68
 
Health insurer fees70 — 209 — 
Operating income274
 280
Operating income$289 $257 $987 $802 
   
Interest expense$21
 $23
Interest expense27 22 72 67 
Other income, net
 (3)
Other expense (income), netOther expense (income), net— (15)
Income before income tax expense253
 260
Income before income tax expense262 233 910 750 
Income tax expense75
 62
Income tax expense77 58 271 181 
Net income178
 198
Net income185 175 639 569 
   
Net income per share - Diluted$2.92
 $2.99
Net income per share - Diluted$3.10 $2.75 $10.65 $8.80 
   
Operating Statistics:   Operating Statistics:
Ending total membership3,404,000
 3,393,000
Ending total membership4,033,000 3,346,000 4,033,000 3,346,000 
MCR (1)
86.3% 85.3%
MCR (1)
85.9 %86.3 %84.9 %85.7 %
G&A ratio (2)
7.0% 7.3%
G&A ratio (2)
7.3 %7.6 %7.3 %7.6 %
Premium tax ratio (1)
3.4% 3.4%
Premium tax ratio (1)
3.4 %2.8 %3.4 %2.9 %
Effective income tax rate29.8% 23.8%Effective income tax rate29.5 %24.7 %29.8 %24.1 %
After-tax margin (2)
3.9% 4.8%
After-tax margin (2)
3.7 %4.1 %4.5 %4.5 %
________________________
(1)
(1)    MCR represents medical care costs as a percentage of premium revenue; premium tax ratio represents premium tax expenses as a percentage of premium revenue plus premium tax revenue.
(2)G&A ratio represents general and administrative expenses as a percentage of total revenue. After-tax margin represents net income as a percentage of total revenue.

(2)    G&A ratio represents general and administrative expenses as a percentage of total revenue. After-tax margin represents net income as a percentage of total revenue.

CONSOLIDATED RESULTS
NET INCOME AND OPERATING INCOME
Net income in the firstthird quarter of 2020 amounted to $178$185 million, or $2.92$3.10 per diluted share, compared with $198$175 million, or $2.99$2.75 per diluted share, in the firstthird quarter of 2019. Operating income of $274$289 million in the firstthird quarter of 2020, was lowerhigher compared with $280$257 million in the firstthird quarter of 2019.
Net income in the nine months ended September 30, 2020, amounted to $639 million, or $10.65 per diluted share, compared with $569 million, or $8.80 per diluted share, in the nine months ended September 30, 2019. Operating income of $987 million in the nine months ended September 30, 2020, was higher compared with $802 million in the nine months ended September 30, 2019.
The improvement in operating income for both periods was mainly due to higher premium revenues and a reduction in the MCR.
Net income per share in the third quarter and nine months ended September 30, 2020, was favorably impacted by the reduction in our common shares outstanding as a result of our share repurchase program.program that began in late 2019 and concluded in the first quarter of 2020. See further discussion in “Liquidity and Financial Condition,” below.
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PREMIUM REVENUE
Premium revenue increased $352$684 million in the firstthird quarter of 2020, when compared with the firstthird quarter of 2019, and increased $1,359 million in the nine months ended September 30, 2020, when compared with the nine months ended September 30, 2019.
In both periods, the higher premium revenue reflected the increase in membership, primarily in Medicaid, and included the impact from the YourCare and Passport acquisitions. In the third quarter of 2020, we added 325,000 members from our acquisition of the Kentucky Passport business on September 1, 2020, and 47,000 members from our acquisition of the New York YourCare business on July 1, 2020. The increase in premium revenues from these acquisitions was slightly offset by the decline in membership, in the Medicaid and Medicare programs, and was mainly due to a 10%third quarter of 2020, associated with our announced exit of operations in Puerto Rico. The increase in premium revenue per-member per-month (“PMPM”), partially offset by a slight declinewas net of COVID-related premium refunds that were enacted in member months.

several states.
MEDICAL CARE RATIO
The consolidated MCR forin the firstthird quarter of 2020 increaseddecreased to 86.3%85.9%, compared to 85.3% for86.3% in the firstthird quarter of 2019, reflecting an increaseimproved operating performance in Medicaid and Medicare, partially offset by underperformance in the Marketplace MCR. program. Additionally, the net effect of all of the COVID-related impacts, such as the reduced demand for medical services and the premium refunds, profit corridors and related actions, had a slightly favorable impact on our overall financial results.
The prior period reserve developmentconsolidated MCR in the nine months ended September 30, 2020, decreased to 84.9%, compared to 85.7% in the nine months ended September 30, 2019. Reserve development for the first quarternine months of 2020 was negligible.not material. The first quarter of 2019comparable period in the prior year was positively impacted by approximately 140100 basis points of favorable reserve development, primarily in the Medicaid line of business. Given the timing of the COVID-19 outbreak and related progression, the impact of COVID-19 on the MCR was limited in the quarter.program.
PREMIUM TAX REVENUE AND EXPENSES
The premium tax ratio (premium tax expense as a percentage of premium revenue plus premium tax revenue) was 3.4% in the firstthird quarter of 2020, consistentcompared with 2.8% the firstthird quarter of 2019; and 3.4% compared with 2.9% for the nine months ended September 30, 2020 and 2019, respectively. The current year ratio increase was mainly due to the state of Illinois’ implementation of a managed care organization provider assessment in the third quarter of 2019.
INVESTMENT INCOME AND OTHER REVENUE
Investment income and other revenue was $29decreased to $14 million in the firstthird quarter of 2020, and was unchanged compared with $40 million in the firstthird quarter of 2019. We expect investment income2019, and decreased to decline$61 million in the nine months ended September 30, 2020, compared with 2019, as money market$103 million in the nine months ended September 30, 2019. The year-over-year decrease was consistent with our expectation and other maturing fixed income investments roll overwas due to lower yielding instruments.the low interest rate environment.
G&A EXPENSES
The G&A expense ratio decreased to 7.0%7.3% in the firstthird quarter of 2020, from 7.6% in the third quarter of 2019, and decreased to 7.3% in the first quarter of 2019,nine months ended September 30, 2020, compared with 7.6% in the nine months ended September 30, 2019. In both periods, the ratio improved due to increased revenues. The current quarter also reflects $6 million of incremental expenserevenues, partially offset by increased costs associated with the mobilizationCOVID-19 pandemic. The third quarter and nine months ended September 30, 2020, reflected approximately $7 million and $38 million, respectively, of our workforce to work at home and othernet incremental expenses associated with a variety of new COVID-related operational protocols, related to COVID-19.technology implementations, and benefits for our employees.
HEALTH INSURER FEES (“HIF”)
In the firstthird quarter of 2020 and the nine months ended September 30, 2020, HIF expense amounted to $68$70 million and $209 million, respectively, and HIF reimbursements amounted to $66 million.$69 million and $206 million, respectively. Public Law No. 115-120 provided for a HIF moratorium in 2019; therefore, there was no HIF incurred or reimbursed in that year. The HIF iswas reinstated in 2020, but the Further Consolidated Appropriations Act, 2020, repealed the HIF effective for years after 2020.
INTEREST EXPENSE
Interest expense declinedincreased to $21$27 million in the firstthird quarter of 2020, from $23compared with $22 million in the firstthird quarter of 2019, and increased to $72 million in the nine months ended September 30, 2020, compared with $67 million in
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the nine months ended September 30, 2019. Additional interest expense relating to the 4.375% Notes issued in June 2020 was partially offset by the decrease in interest expense resulting from the settlement of the convertible senior notes in January 2020. As further described below in “Liquidity,” we repaida portion of the $12net proceeds from the 4.375% Notes offering was used to repay $600 million principal amount outstanding under the term loan facility of our 1.125% Convertible Notes in the first quarter of 2020.
OTHER INCOME, NET
In the first quarter of 2019, we recognized gains on debt repayment of $3 million, in connection with convertible senior notes repayment transactions, with no corresponding gain in the first quarter of 2020.prior credit agreement. See further discussion in Notes to Consolidated Financial Statements, Note 7, “Debt.8, “Debt.
OTHER EXPENSE (INCOME), NET
In the nine months ended September 30, 2020, we recognized losses on debt repayment of $5 million in connection with repayment of our term loan facility and other financing transactions. In the third quarter and nine months ended September 30, 2019, we recognized a loss on debt repayment of $2 million, and a gain on debt repayment of $15 million, respectively, in connection with convertible senior notes repayment transactions.
INCOME TAXES
Income tax expense amounted to $75$77 million in the firstthird quarter of 2020, or 29.5% of pretax income, compared with income tax expense of $58 million, or 24.7% of pretax income in the third quarter of 2019. Income tax expense amounted to $271 million in the nine months ended September 30, 2020, or 29.8% of pretax income, compared with income tax expense of $62$181 million, or 23.8%24.1% of pretax income in the first quarter ofnine months ended September 30, 2019. The effective tax rate ishas been higher in 2020 due to higher nondeductible expenses in 2020, primarily related to the nondeductible HIF. TheAs discussed above, the HIF was not applicable in 2019 due to the moratorium as noted above.and has been repealed for years after 2020.

REPORTABLE SEGMENTS
We currently have two reportable segments: the Health Plans segment and the Other segment. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.
HOW WE ASSESS PERFORMANCE
We derive our revenues primarily from health insurance premiums. Our primary customers are state Medicaid agencies and the federal government.
The key metrics used to assess the performance of our Health Plans segment are premium revenue, margin and MCR. MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the

underlying margin, or the amount earned by the Health Plans segment after medical costs are deducted from premium revenue, is the most important measure of earnings reviewed by management.
Margin for our Health Plans segment is referred to as “Medical Margin.” Medical Margin amounted to $588$670 million in the firstthird quarter of 2020, and $581$561 million in the firstthird quarter of 2019. Medical Margin amounted to $2,032 million in the nine months ended September 30, 2020, and $1,725 million in the nine months ended September 30, 2019. Management’s discussion and analysis of the changes in the individual components of Medical Margin follows.
See Notes to Consolidated Financial Statements, Note 9, “Segments,10, “Segments,” for more information on our reportable segments.


HEALTH PLANS
TheAs of September 30, 2020, the Health Plans segment consistsconsisted of health plans operating in 1415 states and the Commonwealth of Puerto Rico. As of March 31, 2020, these health plansRico, and served approximately 3.44.0 million members eligible for Medicaid, Medicare, and other government-sponsored healthcare programs for low-income families and individuals, including Marketplace members, most of whom receive government premium subsidies.
TRENDS AND UNCERTAINTIES
COVID-19 Pandemic
On March 13, 2020, a national state of emergency was declared over the coronavirus (“COVID-19”) outbreak, to enhance the federal government’s response to the pandemic. At that time, several states had already declared some type of emergency, and by March 16, 2020, every state had made an emergency declaration. Such emergency declarations allow governors to exercise emergency powers that may include activating state emergency personnel and funds, supporting the needs of local governments, and adjusting regulations to maximize access to health care.
Molina Healthcare and its subsidiary health plans across 14 states and Puerto Rico are working diligently and in alignment with federal, state and local public health authorities, regulators, and other health systems to ensure no interruption in service or care coordination to our members, and to proactively protect our employees.
We have activated several internal frameworks and functions designed to mitigate the implications ofAs the COVID-19 pandemic which include acontinues to evolve, its ultimate impact to our business, continuity planresults of operations, financial condition and an enterprise risk management framework, along with executive level cross-functional teams that have been formedcash flows is uncertain and difficult to address other pandemic-specific impacts, including policy coverage, financial solvency, investmentspredict. Specific trends and liquidity, and staff considerations.uncertainties related to our Health Plans segment follow.
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Federal Economic Stabilization Programs
As a result of the pandemic, various laws and other regulatory actionsstabilization programs were enacted at the federal level,beginning in March 2020, which may impact our business directly or indirectly, including the following:
Federal Economic Stabilization Programs
Phase One1 - Coronavirus Preparedness and Response Supplemental Appropriations Act. Enacted on March 6, 2020, this legislation provided $8.3 billion of emergencyin COVID-19 response funding for federal agencies to respond todeveloping a vaccine and preventing further spread of the COVID-19 outbreak.virus.
Phase Two2 - Families First Coronavirus Response Act (the “FFCRA”). Enacted on March 18, 2020, the FFCRAthis legislation provided $100 billion in worker assistance, temporarily increasesincreased each qualifying state and territory’s federal medical assistance percentage (“FMAP”) by 6.2% beginning January 1, 2020, throughout each state’s declaration of emergency.and waived cost sharing for COVID-19 testing. The federal government guarantees matching funds to states for qualifying Medicaid expenditures based on each state’s FMAP.
Effective October 23, 2020, the U.S. Department of Health and Human Services (“HHS”) announced that it has extended the COVID public health emergency for another 90 days. The renewal extends the emergency period until late January 2021. As a result, the enhanced FMAP rate will be extended through the end of the first quarter of 2021. The accompanying requirement that bans the loss of coverage from state eligibility redeterminations would be extended through the end of January 2021. Redetermination is the process through which Medicaid enrollees demonstrate whether they continue to meet the requirements for participation in the Medicaid program, in particular maximum household income. This is likely a positive indicator for continued membership gains, and to provide more support for an actuarially sound rate environment.
Phase Three3 - Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”). Enacted on March 27, 2020, the CARES Act providesprovided an estimated $2 trillion to fight the COVID-19 pandemic and stimulate the USU.S. economy. This assistance includes $349included loans and support to major industries, including airlines and small businesses, direct payments to individuals and families, and $175 billion for small business loans that will help providers cover qualified payroll costs, rent, utilities, and interest on mortgagein relief funds to hospitals and other debt obligations; $100 billion for health care providers to cover healthcare-related expenses or lost revenues directly attributable to COVID-19;healthcare providers.
Phase 3b - Paycheck Protection Program and Medicare and Medicaid provisions that should help providers broadly, including a 20% boost to the Medicare rate on COVID-19 cases.Health Care Enhancement Act
The latest COVID-19 economic relief package was enacted. Enacted on April 24, 2020, this legislation provided $310 billion for the depleted Paycheck Protection Program, and provides $484 billion to replenish a small business lending program, and supportadditional funding for hospitals and COVID-19 testing.

The Phase 4 stimulus package is currently under consideration by Congress.
Due to the uncertainty aroundas to the duration and breadth of the COVID-19 pandemic, we are unable to reasonably estimate the ultimate impact of the economic stabilization programs to our business, financial condition, and operating results at this time.results.
Regulatory Relief for Medicaid, Medicare and Marketplace Enrollees
Medicaid and Medicare Waivers. The Secretary of Health and Human Services can use “Section 1135” authority to waive or modify certain Medicare, Medicaid, and CHIP requirements to ensure that sufficient health care items and services are available to meet the needs of Medicaid enrollees in affected areas if a public health emergency has been declared. After the state of emergency declaration noted above, the Center for Medicare and Medicaid Services (“CMS”) issued blanket Section 1135 waivers for many Medicare provisions and approved Section 1135 waivers for Medicaid programs in many states. The Commonwealth of Puerto Rico and all the states with which Molina contracts for Medicaid services have either submitted or are in the process of submitting Section 1135 waivers.Plan Operations
The waivers that impact the operations of Medicaid managed care organizations include: extension of members’ pre-existing authorizations for health services; reduction of the timeline to resolve members’ appeals; suspension of pre-admission screening for certain conditions; payment for services performed by certain out of state providers or other facilities; elimination of cost-sharing for COVID-19 related healthcare services; expansion of telehealth benefits; and relaxation of appeals requirements for Medicare Advantage members.
Due to the uncertainty around the duration and breadth of the COVID-19 pandemic we are unable to reasonably estimate the ultimate impact of the Section 1135 waivers tohas impacted our business, financial condition, and operating results at this time.
Trends and Uncertainties
Wewe currently expect the pandemicit to further impact our business in the following areas:areas described below. As noted above, in the third quarter of 2020 the combination of COVID-related impacts netted to a negligible to slightly positive impact on earnings.
Medical Care Costs and Demand for Healthcare Services. Beginning in early 2020 the pandemic, along with the related quarantine and social distancing measures, initially reduced demand for certain routine and non-critical medical services, while at the same time increased demand for other medical services, such as COVID-19 testing and emergency services. Early in the second quarter of 2020, we experienced significantly lower utilization in a variety of cost categories, representing approximately two-thirds of our total medical cost spend, with utilization levels increasing slowly as the quarter progressed. We experienced several significant COVID-related impacts on medical care costs in the third quarter of 2020 as follows:
At the beginning of the third quarter of 2020, utilization was still moderately curtailed, but rebounded to more normal levels during the quarter.
We attracted approximately 300,000 new Medicaid members since March 31, 2020, and we believe that the acuity of that population is lower than our average.
Direct costs to care for COVID patients totaled $35 million in the third quarter of 2020, as a resurgence of COVID infections and episodes has occurred in places such as Texas and California, and also disproportionately impacted certain of our Marketplace members.
In the third quarter of 2020, the net effect of these three factors reduced medical care costs and increased pretax earnings by a range of approximately $95 million to $105 million.
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Medicaid Premium Actions. Various states have implemented temporary premium refunds and related actions in response to the reduced demand for medical services stemming from COVID-19, which are resulting in a reduction of our medical margin. In some cases, these premium actions are retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. In the second quarter of 2020, we recognized approximately $75 million for certain of these retroactive premium actions that we believe to be probable, and where the ultimate premium amount is reasonably estimable. In most of those states, the refund period extended into the third quarter of 2020, and one additional state, Michigan, enacted a premium refund mechanism in the third quarter of 2020. Consequently, we recognized an additional $88 million related to these retroactive premium actions in the third quarter of 2020, resulting in $163 million recognized in the nine months ended September 30, 2020.
It is possible that certain states could increase the level of existing premium refunds, and it is also possible that other states could implement some form of retroactive premium refund during the fourth quarter of 2020. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows.
Our position on rate adequacy has been consistent:
We do not intend, nor do we want, to keep state Medicaid money that was supposed to be spent on medical benefits but was not due to utilization curtailment caused by COVID;
In many of our Medicaid states, there are already mechanisms in place to protect against a surplus margin, as there are Minimum MLRs in seven of our states and profit caps in two others; and
Once the COVID-19 pandemic abates, we believe that the traditional process of establishing prospective actuarially sound rates based on a credible medical cost baseline and cost trend off that baseline will resume.
Member Enrollment. As a resultWe added 625,000 Medicaid members as of September 30, 2020, compared with our Medicaid membership as of March 31, 2020, when we first began to report on the impacts of the surgepandemic. Included in unemploymentthis total are 325,000 members added from our acquisition of the Kentucky Passport business on September 1, 2020. The 47,000 member increase from our acquisition of the New York YourCare business on July 1, 2020, was offset by the decline in membership, in the third quarter of 2020, associated with our announced exit of operations in Puerto Rico. The remaining 300,000 increase in membership was mainly due to the pandemic,suspension of redeterminations, as we expectbelieve that unemployment-related enrollment has not yet materially accessed managed Medicaid.
It remains unclear how high the COVID-related membership peak will be, how quickly it will fall as the economy recovers, and where it will ultimately settle. However it does now appear that since unemployment nationally is now just under 8%, the initial industry estimates of unemployment-related Medicaid membership increases were somewhat overstated. On a significant increase in Medicaid eligibility and enrollment. However, due torelated note, the evolving naturedeclaration of the pandemic,extension of the public health emergency period into next year will also likely have an impact. Therefore, we are currently unable to predict the timing or amount of the expected increases in enrollment. Increased membership would increase our premium revenue, but would also likely result in a significant increase in medical care claims and related costs. We believe that we have the scalability necessary to handle the wave ofboth serve new membership that could occurmembers, and be an ableably partner towith our state customers.
In addition to increased Medicaid enrollment, several states that operate their own Marketplaces have reopened enrollment, or extended the deadline to enrollcustomers for increases in the Marketplace, including where we operate in California, New York and Washington. In addition, households previously commercially insured at the workplace that do not qualify for Medicaid may be eligible for highly subsidized Marketplace products.
Demand for Healthcare Services. The pandemic, along with the related quarantine and social distancing measures, is currently reducing demand for certain routine and non-critical medical services, while at the same time increasing demand for other medical services, such as COVID-19 testing and emergency services. Discretionary utilization could continue to be lower than normal patterns for the second quarter, but then may rebound quickly in the second half of 2020 as COVID-19 care abates and health system capacity frees up, and the current social distancing measures are relaxed over time. In addition, we expect increased Medicaid enrollment to result in an increase in medical care claims and related costs.
Therefore, at this point, we cannot predict with any degree of precision how the COVID-19 situation will impact medical costs in 2020. The level of future direct COVID-19 related costs, the incidence rate of diagnosis and hospital admission and the related cost per episode, is not yet estimable. We do not know exactly when utilization patterns and levels will begin to normalize for elective medical procedures. Additionally, any potential short-term and non-recurring benefit from lower utilization would be partially limited by annual Medicare and Marketplace minimum MLR regulations; and annual Medicaid minimum MLR regulations or profit ceilings in eight of the 14 states, including Puerto Rico, in which we operate Medicaid programs.
To provide our members with immediate access to medical care without leaving their homes, and mitigate a potential surge in “pent-up” demand, Molina is:
Providing supplemental telemedicine for our members through our partnership with Teladoc;
Continuing to monitor and update all other tele-health services based on Medicaid agency updates; and
Outreaching to and educating members on community resources as well as their ability to receive free home delivery of prescriptions through CVS Pharmacy.

We are also covering screening tests for COVID-19, including office visits, urgent care, or ER visits associated with testing.
Providers. As noted above, in the near term the pandemic has caused reduced demand for certain routine and non-critical medical services, which in turn is creating financial stress for certain Medicaid providers. State Medicaid agencies have turned to managed care organizations, either explicitly or via CMS Section 1135 waivers (as described above) to provide temporary cash advances to impacted providers for insolvency protection. We have established policies to support our provider network by directing providers to programs that are available under the economic stabilization programs described above. An example of such a program is CMS’s Accelerated Advance Payments program, which can provide three months of payments for healthcare providers. We believe that our provider payment policies will mitigate the risk of an increase in provider receivables that may be uncollectible.
Workforce. Our most significant operational asset is our workforce of nearly 10,000 employees nationwide. On March 18, 2020, we announced that we had temporarily transitioned thousands of our employees to remote status. This precaution was taken to protect the health and wellness of our staff by reducing the likelihood of exposure to COVID-19. As of March 24, 2020, substantially all employees were transitioned to remote status. As of March 31, 2020, we have not experienced any significant interruptions in the services we provide, nor was there a material impact of the pandemic to our consolidated financial position, results of operations, and cash flows in the first quarter of 2020.
Outsourcing and Other Vendors. Our business is dependent on effective and secure information systems. We have partnered with third parties to support our information technology systems. The pandemic may impact the ability of our outsourced information technology service providers, and other third-party vendors, to perform contracted services.membership.
Capital and Financial Resources. Refer to “Liquidity and Financial Condition” below for a discussion of potential pandemic-related impacts to our capital and financial resources.
We continue to monitor and assess the estimated operating and financial impact of the COVID-19 pandemic. However,pandemic, and as it evolves, we are limited in our abilitycontinue to estimate the ultimate impact on our operations (including claims volumes), financial results,process, assemble, and cash flows at this time. Due to the evolving nature of the pandemic, we are continually processing, assembling and assessing information on utilization.assess member utilization information. We believe that our cash resources, borrowing capacity available under ourthe Credit Agreement, and cash flow generated from operations will be sufficient to withstand the financial impact of the pandemic, and will enable us to continue to support our operations, regulatory requirements, debt repayment obligations, and capital expenditures for the foreseeable future.
Affordable Care Act
In December 2018, in a case brought by the state of Texas and nineteen other states, a federal judge in Texas held that the ACA’s individual mandate is unconstitutional. He further held that since the individual mandate is inseverable from the entire body of the ACA, the entire ACA is unconstitutional. The effect of his ruling was stayed pending the appeal of the ruling to the Fifth Circuit Court of Appeals. In December 2019, a three-judge panel of the Fifth Circuit Court of Appeal, in a two to one decision, affirmed the District Court’s ruling that the individual mandate
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is unconstitutional, but remanded the case back to the District Court for additional analysis and findings regarding severability and the consideration of additional arguments.
The U.S. Supreme Court has accepted the appeal of the Fifth Circuit Court’s decision. Oral arguments before the Supreme Court are scheduled to take place on November 10, 2020, and a decision is expected in the first half of 2021. The ACA remains in effect pending the issuance of the Supreme Court’s opinion.
As of September 30, 2020, we served a significant number of members enrolled in programs created by the ACA, including approximately 730,000 Medicaid Expansion members and 325,000 Marketplace members. In the nine months ended September 30, 2020, premium revenue associated with these members amounted to $3,644 million, and contributed Medical Margin of $681 million. A decision by the Supreme Court that the entirety of the ACA is unconstitutional could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Other Recent Developments
New York. In September 2020, we entered into a definitive agreement to acquire substantially all of the assets of Affinity Health Plan, Inc. The net purchase price for the transaction is approximately $380 million, subject to various adjustments at closing, which we intend to fund with cash on hand. We currently expect the transaction to close as early as the second quarter of 2021.
On July 1, 2020, we closed on the acquisition of certain assets of YourCare Health Plan, Inc., a Medicaid health plan, for a cash purchase price of $42 million. In connection with this transaction, we added approximately 47,000 Medicaid members in New York.
Kentucky. On September 1, 2020, we closed on the acquisition of certain assets of Passport Health Plan, Inc., a Medicaid health plan. Effective on that same date, the Kentucky Medicaid agency approved the novation of Passport’s Medicaid contract to Molina Healthcare of Kentucky, Inc. As a result, we added approximately 325,000 Medicaid members in Kentucky.
In May 2020, our Kentucky health plan had been selected as an awardee pursuant to the statewide Medicaid managed care RFP issued by the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services. On October 23, 2020, pursuant to a protest filing appeal with regard to the RFP awards, a court ordered the addition of a sixth health plan to the Kentucky Medicaid program for 2021. That ruling did not rescind the Medicaid contract award to our Kentucky health plan for 2021, nor did it have any impact on the earlier novation of the Passport Medicaid contract to us. The new Medicaid contract is currently expected to begin on January 1, 2021.
Acquisition of Magellan Complete Care. OnIn April 30, 2020, we entered into a definitive agreement to acquire the Magellan Complete Care (“MCC”)MCC line of business of Magellan Health, Inc. The purchase price for the transaction is approximately $820 million, net of certain tax benefits, which we intend to fund with cash on hand.
MCC is a managed care organization serving members in 6six states, including Medicaid members in Arizona and statewide in Virginia.Virginia, and Integrated Acute Care members in Florida. Through its Senior Whole Health branded plans, MCC provides fully integrated plans for Medicaid and Medicare dual beneficiaries in Massachusetts, as well as Managed Long TermLong-Term Care (“MLTC,” commonly known nationally as “MLTSS”) in New York. MCC also provides consultative services to participants who self-direct their care through Wisconsin’s long-term services and supports (“LTSS”) program. As of December 31, 2019, MCC served approximately 155,000 members in managed care plans and provided services to 25,000 LTSS program participants in Wisconsin, with full year 2019 revenues greater thanover $2.7 billion.
The transaction is subject to federal and state regulatory approvals, and other customary closing conditions, and is expected to close inaround the first quarterend of 2021.2020. In connection with this transaction, Magellan Health, Inc. has agreed to provide certain transition services following the closing.
Marketplace Risk Corridor Ruling. OnIn April 27, 2020, the United States Supreme Court issued its opinion in Maine Community Health Options v. United States. The Supreme Court held that §1342 of the Affordable Care Act obligated the federal government to pay participating insurers the full Marketplace risk corridor amounts calculated by that statute, that such payment obligations survived Congress’ appropriations riders, and that impacted insurers may sue the federal government in the U.S. Court of Federal Claims to recover damages for breach of that obligation. There are no distinguishing factors regarding liability or damages between this case andIn June 2020, the cases we ourselves have brought againstClaims Court granted us judgment in the federal governmentamount of $128.1 million for its failure to pay our Marketplace risk corridors claims for 2014, 2015, and 2016. We have already obtained summary judgment for our 2014 and 2015 risk corridor claims in the approximate amount of $52 million, and we have brought another claim for approximately $76 million for the government’s failure to pay our 2016 risk corridor claims. The timing of recognition and collection of these

outstanding Marketplace risk corridor claims, is uncertain, butwhich we received in October 2020. Since we accounted for the judgment as a gain contingency at September 30, 2020, it will request that the Court of Claims act as expeditiously as possible to enterbe recognized in our fourth quarter 2020 financial results. The judgment for all of the risk corridors amounts owed to us.
Puerto Rico. We have decided to sell our Puerto Rico Medicaid business. In doing so, we will work closely with the regulatory authorities and the provider community, to ensure that our members in Puerto Rico are cared for and have reliable continuity of care.does not create additional Minimum MLR rebates.
Illinois. In March 2020, we terminated our agreement to acquire all of the capital stock of NextLevel Health Partners, Inc. due to the seller’s stated unwillingness to close pursuant to the terms of the acquisition agreement.
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Other RFPsTable of Contents
Puerto Rico. We awaitwill exit Puerto Rico’s Medicaid program when our current contract expires on October 31, 2020. We are working closely with the decision byregulatory authorities and the stateprovider community to ensure that our members in Puerto Rico have reliable continuity of Kentucky on its Medicaid RFP, whichcare. As discussed in the Notes to Consolidated Financial Statements, Note 2, “Significant Accounting Policies,” we expect to be issued beforerecognized a $10 million premium deficiency reserve at September 30, 2020, in connection with the end of the second quarter. We believe there will be a general tendency by states to delay procurements until the COVID-19 crisis has abated.exit from this business.
Update on Status of Significant Medicaid Contracts
California. Our managed care contracts with the California Department of Health Care Services (“DHCS”) cover six regions in central and southern California (including the Los Angeles region covered under a separate subcontract with Health Net)Net, LLC). These contracts are effective through December 31, 2020, and are expectedwhich we expect to be renewed annually until the effectiveness of new forms of contract following request for proposal (“RFP”)RFP awards. DHCS has publicly indicated it expects to release the final Medicaid RFP in mid-2021,2021, for implementation in January 2024.
Ohio. Our managed care contract with the Ohio Department of Medicaid (“ODM”) is effective through July 1, 2021. In September 2020, the ODM released the RFP for the Ohio Medicaid program with a due date of November 20, 2020. The program will be regionally based on the current three regions (Central/Southeast, Northeast and West); plans may bid on one or all regions, and be awarded one or all regions. The contracts will be awarded on
January 25, 2021, with a go-live date of January 5, 2022.
Texas. On March 25, 2020, the HHSCTexas Health and Human Services Commission (“HHSC”), notified our Texas health plan that HHSC hashad upheld our protest and had canceled all previously awarded contracts associated with theirthe re-procurement awards announced in October 2019 for the ABD program (known in Texas as “STAR+PLUS”) re-procurement awards announced in October 2019, and. In addition, HHSC canceled the solicitationpending re-procurement associated with theirthe TANF and CHIP programs (known in Texas as “STAR/CHIP”) re-procurement.. HHSC further indicated that it is currentlywas deliberating next steps with respect to both re-procurements.re-procurements. We do not expect the HHSC to re-issue the RFPs in the near future. Previously,
Update on Status of MMP Contracts
Our MMP contracts in October 2019, the HHSC had awarded contractsCalifornia, Illinois and Ohio are effective through December 31, 2022. Updates to our current Michigan, South Carolina and Texas health planMMP contracts are described below. The Michigan, South Carolina and Texas MMP contracts represented aggregate revenues of approximately $586 million in nine months ended September 30, 2020.
Michigan. A one-year contract extension has been executed, through December 31, 2021. The state has submitted a formal letter of intent to extend the contract for five years through 2026; the STAR+PLUS program in two service areas, consisting of one legacy service areafive-year contract extension is under development.
South Carolina. A three-year contract extension has been executed, effective through December 31, 2023.
Texas. A three-year contract extension amendment, through December 31, 2023, is under review and one new service area. This would have been a reduction from our current footprint of six service areas. Also, in 2019, our Texas health plan submitted an RFP response for STAR/CHIP.pending full execution.
For a discussion of additional Health Plans segment trends, uncertainties and other developments, refer to our 2019 Annual Report on Form 10-K, “Item 1. Business—Our Business,” and “—Legislative and Political Environment.”

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MEMBERSHIP
The following tables set forth our Health Plans segment membership as of the dates indicated:
September 30,
2020
December 31,
2019
September 30,
2019
Ending Membership by Government Program:
Medicaid3,595,000 2,956,000 2,955,000 
Medicare113,000 101,000 102,000 
Marketplace325,000 274,000 289,000 
Total4,033,000 3,331,000 3,346,000 
Ending Membership by Health Plan:
California584,000 565,000 580,000 
Florida136,000 132,000 136,000 
Illinois282,000 224,000 224,000 
Kentucky (1)
325,000 — — 
Michigan391,000 362,000 361,000 
Ohio348,000 288,000 292,000 
South Carolina153,000 131,000 134,000 
Texas357,000 341,000 350,000 
Washington947,000 832,000 818,000 
Other (2)
510,000 456,000 451,000 
Total4,033,000 3,331,000 3,346,000 
_________________________
(1)
 March 31,
2020
 December 31,
2019
 March 31,
2019
Ending Membership by Government Program:     
Medicaid2,970,000
 2,956,000
 2,964,000
Medicare105,000
 101,000
 97,000
Marketplace329,000
 274,000
 332,000
Total3,404,000
 3,331,000
 3,393,000
      
Ending Membership by Health Plan:     
California550,000
 565,000
 600,000
Florida123,000
 132,000
 144,000
Illinois230,000
 224,000
 219,000
Michigan367,000
 362,000
 369,000
Ohio300,000
 288,000
 295,000
Puerto Rico170,000
 176,000
 207,000
South Carolina136,000
 131,000
 126,000
Texas345,000
 341,000
 377,000
Washington878,000
 832,000
 815,000
Other (1)
305,000
 280,000
 241,000
Total3,404,000
 3,331,000
 3,393,000
_________________________On September 1, 2020, we closed on the acquisition of certain assets of Passport Health Plan, Inc., a Medicaid health plan. Effective on that same date, the Kentucky Medicaid agency approved the novation of Passport’s Medicaid contract to Molina Healthcare of Kentucky, Inc.
(1)“Other” includes the Idaho, Mississippi, New Mexico, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.

(2)“Other” includes the Idaho, Mississippi, New Mexico, New York, Puerto Rico, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.

FINANCIAL PERFORMANCE
The tables in the section below summarize premium revenue, Medical Margin, and MCR by state health plan and by government program for the periods indicated (dollars in millions):
Health Plan PerformanceHEALTH PLANS
Three Months Ended September 30,
20202019
Premium RevenueMedical MarginMCRPremium RevenueMedical MarginMCR
California$554 $87 84.3 %$567 $111 80.3 %
Florida166 27 83.5 171 19 89.0 
Illinois339 32 90.5 257 25 90.6 
Kentucky169 16 90.7 — — — 
Michigan398 76 80.8 408 72 82.3 
Ohio808 124 84.6 640 58 91.0 
South Carolina158 18 88.8 151 13 91.6 
Texas801 104 87.1 734 89 87.8 
Washington807 116 85.7 688 85 87.7 
Other (1)
568 70 87.6 468 89 80.9 
Total$4,768 $670 85.9 %$4,084 $561 86.3 %

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Three Months Ended March 31,Nine Months Ended September 30,
2020 201920202019
Premium  Revenue Medical Margin MCR Premium  Revenue Medical Margin MCRPremium RevenueMedical MarginMCRPremium RevenueMedical MarginMCR
 
California$551
 $85
 84.5% $555
 $74
 86.7%California$1,660 $280 83.1 %$1,682 $295 82.4 %
Florida154
 30
 80.4
 223
 70
 68.4
Florida482 82 83.0 570 115 79.9 
Illinois308
 34
 89.1
 227
 42
 81.2
Illinois953 116 87.8 726 94 87.1 
KentuckyKentucky169 16 90.7 — — — 
Michigan411
 74
 82.0
 405
 74
 81.7
Michigan1,224 256 79.1 1,226 221 81.9 
Ohio720
 83
 88.5
 620
 68
 89.2
Ohio2,279 326 85.7 1,914 208 89.2 
Puerto Rico105
 (2) 101.5
 102
 12
 88.1
South Carolina157
 19
 87.8
 136
 21
 85.1
South Carolina472 60 87.3 427 49 88.7 
Texas743
 91
 87.7
 747
 106
 85.9
Texas2,273 276 87.9 2,246 292 87.0 
Washington773
 113
 85.5
 661
 46
 93.0
Washington2,351 364 84.5 2,011 223 88.9 
Other (1)
382
 61
 83.9
 276
 68
 75.2
Other (1)
1,581 256 83.7 1,283 228 82.2 
Total$4,304
 $588
 86.3% $3,952
 $581
 85.3%Total$13,444 $2,032 84.9 %$12,085 $1,725 85.7 %
__________________
(1)“Other” includes the Idaho, Mississippi, New Mexico, New York, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.

(1)“Other” includes the Idaho, Mississippi, New Mexico, New York, Puerto Rico, Utah and Wisconsin health plans, which are not individually significant to our consolidated operating results.
In summary, we believe
As discussed in “Trends and Uncertainties” above, the combination of all the COVID-19 pandemic-related impacts netted to a negligible to slightly positive impact on our health plan portfolio performance was essentially in line with expectations inoverall financial results for the firstthird quarter of 2020, despite cost pressures in certain Medicaid markets. The2020. Some of these items increased earnings, such as lower than expected medical costs from the curtailment of utilization that benefited all our state health plans, most impactedand a meaningful increase in Medicaid membership, while others served to decrease earnings, such as the temporary, retroactive Medicaid premium refunds and related actions enacted by COVID-19 are Washington, California, and Michigan. While Washington was the first state impacted, Michigan has experienced the highest number of cases. The net impact was not material, however, as these increased costs were offset by the reduced demand for certain routine and non-critical medical services. states.
Comments relating to the performance of our health plans in California, Ohio, Texas and Washington, which represent our largest health plans from a premium revenue standpoint, follow:
Our CaliforniaCalifornia. For the third quarter and nine months ended September 30, 2020, Medical Margin declined as the lower medical costs from the curtailment of utilization were more than offset by Medicaid premium actions and underperformance in the Marketplace.
Ohio. For the third quarter and nine months ended September 30, 2020, Medical Margin was higher when compared with the same periods in 2019 due to higher premiums and improved operating performance in Medicaid. Premium revenues were higher year-over-year, mainly due to increased membership, program changes and rate increases in Medicaid established before COVID-19. In the third quarter of 2020, the combined impacts from COVID-19 were negligible; however, the health plan continuesexperienced a modest benefit for the nine months ended September 30, 2020, as lower medical costs from the curtailment of utilization slightly exceeded the impact of retroactive Medicaid premium refunds and related actions.
Texas. For the third quarter of 2020, Medical Margin improved compared with the third quarter of 2019, due to perform well in its diversified book of business in one of the more complex network environmentsa decrease in the country, andMCR in Medicaid, partially offset by underperformance in Marketplace. For the MCR is performing in the low- to mid-80s asnine months ended September 30, 2020, performance declined year-over-year, with a result of a stable premium rate environment and effective medical cost management.lower Medical margin increased in the first quarter of 2020Margin compared with the same period in 2019,2019. The decline resulted mainly from underperformance in Marketplace, due primarily to an improvementlower premiums and higher acuity mix for the new members we now serve, partially offset by lower MCRs in Medicaid and Medicare.
Washington. For the MCR.
In Ohio, premium revenuesthird quarter and nine months ended September 30, 2020, Medical Margin have increased due towas higher premium revenue PMPMwhen compared with the same periods in Medicaid, resulting from rate increases.
Our Texas health plan experienced a decline2019, mainly driven by improved results in both premium revenues and Medical Margin in 2020, mainly due to the overall decline in Marketplace membership, and higherMedicaid. Medicaid and Marketplace MCRs. The Medicaid MCR increased due to higher medical care costs PMPM. The Marketplace MCR increased due to lower pricing and was in line with our expectations.
In Washington, premium revenues increased in both the third quarter and nine months ended September 30, 2020, due to Medicaid and Marketplace membership growth. We have a well-diversified portfolio of products and our Medical Margin performance improved year-over-yeargrowth in Medicaid. In addition, results in the nine months ended September 30, 2020, benefited modestly from lower medical costs due to the premium growth and improved MCR. The MCR improved, despite some pressurecurtailment of utilization driven by COVID-19, which was partially offset by COVID-related provider payments mandated by the state in medical care costs, due to higher premium revenue PMPM in Medicaid and our continuing increased focus on medical care management.
Government Program Performancethe second quarter of 2020.
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 Three Months Ended March 31,
 2020 2019
 Premium  Revenue Medical Margin MCR Premium  Revenue Medical Margin MCR
      
Medicaid$3,286
 $365
 88.9% 3,004
 346
 88.5%
Medicare634
 117
 81.7
 551
 85
 84.7
Marketplace384
 106
 72.3
 397
 150
 62.2
 $4,304
 $588
 86.3% $3,952
 $581
 85.3%
PROGRAMS
Three Months Ended September 30,
20202019
Premium RevenueMedical MarginMCRPremium RevenueMedical MarginMCR
Medicaid$3,754 $509 86.4 %$3,168 $378 88.1 %
Medicare632 91 85.6 559 80 85.6 
Marketplace382 70 81.6 357 103 71.2 
Total$4,768 $670 85.9 %$4,084 $561 86.3 %

Nine Months Ended September 30,
20202019
Premium RevenueMedical MarginMCRPremium RevenueMedical MarginMCR
Medicaid$10,415 $1,427 86.3 %$9,239 $1,088 88.2 %
Medicare1,896 333 82.4 1,682 249 85.2 
Marketplace1,133 272 76.0 1,164 388 66.7 
Total$13,444 $2,032 84.9 %$12,085 $1,725 85.7 %
Medicaid
Medicaid premium revenue increased $282$586 million in the firstthird quarter of 2020 when compared with the third quarter of 2019, and increased $1,176 million in the nine months ended September 30, 2020, when compared with the nine months ended September 30, 2019. The increase in both periods was mainly due to highermembership growth and premium revenue PMPMincreases in several states, primarilypartially offset by premium refunds and related actions stemming from COVID-19. The increase in Ohiomembership includes the impact of the Passport members in Kentucky that we assumed on September 1, and Illinoisthe YourCare membership in New York that we assumed on July 1, as well as the impact from suspension of redeterminations due to rate increases,COVID-19.
As described above in “Health Plans—Trends and Uncertainties,” we recognized approximately $88 million and $163 million, respectively, in the third quarter and nine months ended September 2020, for the impact of premium refunds and related actions enacted in several states in response to the lower utilization of medical services resulting from membership growth in Washington.COVID-19.
The Medical Margin in our Medicaid program increased $19$131 million, or 5%35%, in the firstthird quarter of 2020 when compared with the firstthird quarter of 2019, and increased $339 million, or 31% in the nine months ended September 30, 2020, when compared with the nine months ended September 30, 2019. The increase in both periods was driven mainly by the growth inincreased premium revenues partially offset by an increaseand margin associated with the membership growth discussed above, and from a reduction in the MCR.
The Medicaid MCR increaseddecreased to 88.9%86.4% in the firstthird quarter of 2020, from 88.5%88.1% in the firstthird quarter of 2019, or 40170 basis points, and decreased to 86.3% in the nine months ended September 30, 2020, from 88.2% in the nine months ended September 30, 2019, or 190 basis points. The prior yearimprovements were generally present across all our programs. The year-over-year decrease in the third quarter of 2020 was positively impacteddue to increases in the premium revenue per member per month (“PMPM”) and improved operating performance, including enhanced medical cost initiatives. The combined impacts from COVID-19 were negligible to slightly positive in the third quarter of 2020. At the beginning of the third quarter of 2020, utilization was still moderately curtailed but reverted more to normal levels by the aforementioned favorable reserve development.end of the quarter. For the nine months ended September 30, 2020, the MCR benefited from lower medical costs due to the curtailment of utilization from COVID-19, which modestly exceeded the impact of the retroactive Medicaid premium refunds and related actions enacted in several states.
In addition,the third quarter of 2020, we experienced medical cost pressure inrecognized a $10 million premium deficiency reserve (“PDR”) associated with the Puerto Rico Medicaid line ofbusiness. As previously announced, we will exit this business early inwhen our current contract expires on October 31, 2020. The PDR represents the quarter resulting from slightly higher than normal seasonal flu combinedestimated remaining claims and administrative costs that exceed the estimated remaining premiums associated with early, but largely undetected COVID-19 costs diagnosed as severe respiratory illness and pneumonia. We also experienced increased pharmacy costs in the quarter as members pre-filled their chronic medications in advance of the height of the crisis. These increased costs were offset by lower medical care costs very late in the quarter, as elective and discretionary healthcare services began to be postponed and deferred.contract.
The MCR for TANF and CHIP increased 610 basis points, which was partially offset by an improved MCR for the ABD program due to increases in premium revenue PMPM, lower pharmacy costs from re-contracted pharmacy benefits management, and our continued focus on medical cost management.
The decreaserelatively flat in the Medicaid Expansion MCR in the firstthird quarter of 2020, when compared with the firstthird quarter of 2019, while the MCR for the ABD program decreased 180 basis points, and the MCR for Medicaid Expansion decreased by 440 basis points. The MCR for TANF and CHIP reflected the impact of the Puerto Rico PDR
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discussed above. Excluding the PDR, the MCR in all our Medicaid programs improved year-over-year, mainly from increases in the premium revenue PMPM rates and improved operating performance.
For the nine months ended September 30, 2020, the MCR decreased 40 basis points for TANF and CHIP, decreased 190 basis points for ABD, and decreased 440 basis points for Medicaid Expansion, when compared with the same period in 2020. The year-over-year improvement in the nine months ended September 30, 2020, was mainly due to anthe increase in premium revenue PMPM.

PMPM, operating improvements, and the COVID-19 related net impacts. These improvements were partially offset by unfavorable year-over-year changes in prior year reserve development.
Medicare
Medicare premium revenue increased by $83$73 million in the firstthird quarter of 2020 and $214 million in the nine months ended September 30, 2020, primarily due to increases in premium revenue PMPM and member months. PMPMs improved due to increased revenue resulting from risk scores that are more commensurate with the acuity of our population and increases in quality incentive premium revenues.
The Medical Margin for Medicare increased $32$11 million, or 38%14%, in the firstthird quarter of 2020, and increased $84 million, or 34%, in the nine months ended September 30, 2020, when compared with the first quarter of 2019, primarily duesame periods, respectively, in 2019. The year-over-year improvement in both periods was mainly attributed to the increase in premium revenue discussedincreased revenues described above, partially offset by an increase inand to a lesser extent, lower utilization of medical care costs PMPM.services stemming from COVID-19.
The Medicare MCR was unchanged at 85.6% in the third quarter of 2020. The 280 basis point year-over-year decrease in the MCR in the nine months ended September 30, 2020, was also due to the increasesame factors impacting the year-over-year changes in premium revenue PMPMMedical Margin as discussed above, partially offset by an increase in medical care costs PMPM. The increase in medical care costs PMPM was mainly attributed to fluctuations of medical care costs in certain markets.above.
Marketplace
Marketplace premium revenue decreased $13increased $25 million in the firstthird quarter of 2020, drivenbut decreased $31 million in the nine months ended September 30, 2020, mainly by adue to lower pricing in an effort to be more competitive, and lower risk scores that were not commensurate with the risk of the population. The decrease in membership.the nine months period also resulted from the impact of more health plans being subject to minimum medical loss ratio rebates when compared with the prior year, and the benefit from favorable retrospective adjustments to risk adjustment premiums was higher in the prior year.
The Marketplace Medical Margin decreased $44$33 million in the firstthird quarter of 2020, and $116 million in the nine months ended September 30, 2020, when compared with the first quarter of 2019,same periods, respectively, in 2019. In both periods, the Medical Margin decrease was primarily due to the decreasedecline in premium revenues discussed above, and a higher than expected member acuity mix. Our risk scores continue to lag the acuity of our membership, and the increaserebound in utilization for Marketplace has been much more pronounced than our Medicaid and Medicare programs.The COVID-19 related utilization impact was unfavorable to the Marketplace MCR.business and contributed to the year-over-year decline.
The Marketplace MCR increased in the firstthird quarter ofand the nine months ended September 30, 2020, which was mainly attributable to our lowering pricessame factors impacting the year-over-year changes in 2020 in an effort to be more competitive.Medical Margin discussed above.

OTHER
The Other segment includes certain corporate amounts not allocated to the Health Plans segment. Such amounts are immaterial to our consolidated results of operations.


LIQUIDITY AND FINANCIAL CONDITION
LIQUIDITY
We manage our cash, investments, and capital structure to meet the short- and long-term obligations of our business while maintaining liquidity and financial flexibility. We forecast, analyze, and monitor our cash flows to enable prudent investment management and financing within the confines of our financial strategy.
We maintain liquidity at two levels: 1) the regulated health plan subsidiaries; and 2) the parent company. Our Health Plans segment regulated subsidiaries generate significant cash flows from premium revenue, which is generally received a short time before related healthcare services are paid. Premium revenue is our primary source of liquidity. Thus, any decline in the receipt of premium revenue, and our profitability, could have a negative impact on
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our liquidity. In the first quarter ofnine months ended September 30, 2020, we did not experience noticeable delays of, or changes in, the timing and level of premium receipts as a result of the COVID-19 pandemic, but there can be no assurances that we will not experience such delays in the future. See further discussion below regarding various states’ premium actions in “Future Sources and Uses of Liquidity—Future Uses.”
A majority of the assets held by our regulated health plan subsidiaries is in the form of cash, cash equivalents, and investments. When available and as permitted by applicable regulations, cash in excess of the capital needs of our regulated health plan subsidiaries is generally paid in the form of dividends to our parent company to be used for general corporate purposes. In the firstthird quarter ofand nine months ended September 30, 2020, the parent received $50$120 million and $355 million, respectively, in dividends from the regulated health plan subsidiaries. See further discussion of dividends below in “Future Sources and Uses of Liquidity.Liquidity—Future Sources.
To satisfy minimum statutory net worth requirements, theThe parent company may also contribute capital to the regulated health plan subsidiaries.subsidiaries to satisfy minimum statutory net worth requirements, including funding for newer health plans with growing enrollment. In the firstthird quarter ofand nine months ended September 30, 2020, the parent contributed capital of $10 million and $62 million, respectively, to the regulated health plan subsidiaries.
Cash, cash equivalents and investments at the parent company amounted to $841$1,286 million, and $997 million as of March 31,September 30, 2020, and December 31, 2019, respectively. The decrease inincrease as of September 30, 2020, was mainly due to net proceeds of $789 million for the 4.375% Notes issued in June 2020, $380 million drawn on the term loan facility in the first quarter of 2020, and $355 million of dividends received from our regulated health plan subsidiaries year to date. The increase was partially offset by the $600 million repayment of the term loan facility, purchases of our common stock amounting to $453 million, $62 million contributed to our health plan subsidiaries (including $42 million for the YourCare acquisition), $63 million for purchases of property, equipment and capitalized software, $42 million net cash paid for the aggregate 1.125% Convertible Notes-relatedconvertible notes-related transactions, and $20 million for the parent capital contributioninitial cash payment for the Passport acquisition. As described above. These payments were partially offset by proceeds of $380in Note 2,” Significant Accounting Policies,” we received $128.1 million borrowed under our Term Loan Facility and dividends received from regulated health plan

subsidiaries, as described above. We borrowedfor the remaining available capacity under the Term Loan FacilityMarketplace risk corridor settlement in March 2020, to provide us with additional flexibility should there be unexpected events relating to the COVID-19 pandemic impacting our access to the capital markets, or our cash flows.October 2020.
Investments
After considering expected cash flows from operating activities, we generally invest cash of regulated subsidiaries that exceeds our expected short-term obligations in longer term, investment-grade, and marketable debt securities to improve our overall investment return. These investments are made pursuant to board-approved investment policies which conform to applicable state laws and regulations.
Our investment policies are designed to provide liquidity, preserve capital, and maximize total return on invested assets, all in a manner consistent with state requirements that prescribe the types of instruments in which our subsidiaries may invest. These investment policies require that our investments have final maturities of less than 10 years, or less than 10 years average life for structured securities. Professional portfolio managers operating under documented guidelines manage our investments and a portion of our cash equivalents. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels.
We believe that the risks of the COVID-19 pandemic, as they relate to our investments, are minimal. The overall rating of our portfolio remains strong and is rated AA. Our investment policy has directives in conjunction with state guidelines to minimize risks and exposures in volatile markets. Additionally, our portfolio managers assist us in navigating the current volatility in the capital markets.
Our restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities; we have the ability to hold such restricted investments until maturity. All of our unrestricted investments are classified as current assets.

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Cash Flow Activities
Our cash flows are summarized as follows:
 Three Months Ended March 31,
 2020 2019 Change
 (In millions)
Net cash provided by operating activities$136
 $249
 $(113)
Net cash (used in) provided by investing activities(103) 171
 (274)
Net cash used in financing activities(118) (48) (70)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents$(85) $372
 $(457)
Nine Months Ended September 30,
20202019Change
(In millions)
Net cash provided by operating activities$591 $398 $193 
Net cash provided by (used in) investing activities98 (80)178 
Net cash provided by (used in) financing activities69 (510)579 
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents$758 $(192)$950 
Operating Activities
We typically receive capitation payments monthly, in advance of payments for medical claims; however, government payors may adjust their payment schedules, positively or negatively impacting our reported cash flows from operating activities in any given period. For example, government payors may delay our premium payments, or they may prepay the following month’s premium payment.
Net cash provided by operations for the first quarter ofnine months ended September 30, 2020 was $136$591 million, compared with $249$398 million in the first quarter ofnine months ended September 30, 2019. The $113$193 million decreaseincrease in cash flow was due to stronger operating results in the nine months ended September 30, 2020, and the net impact of timing differences in government receivables and payables, and accelerated payments to providers.payables.
Investing Activities
Net cash provided by investing activities was $98 million in the nine months ended September 30, 2020, compared with $80 million used in investing activities was $103 million in the first quarter of 2020, compared with $171 million provided by investing activities in the first quarter ofnine months ended September 30, 2019, a decreasean increase in cash flow of $274$178 million. The year over year declineincrease was primarily due to increaseddecreased purchases of investments in the first quarter ofnine months ended September 30, 2020.
Financing Activities
Net cash provided by financing activities was $69 million in the nine months ended September 30, 2020, compared with $510 million used in financing activities was $118 million in the first quarternine months ended September 30, 2019, an increase in cash flow of 2020, compared with $48 million in the first quarter of 2019.$579 million. In the first quarter ofnine months ended September 30, 2020, cash paid forinflows included $789 million from the issuance of the 4.375% Notes and $380 million borrowed under the term loan facility. Cash outflows included the $600 million repayment of the term loan facility, common stock purchases amounted toof $453 million, which included $7 million to settle shares purchased in late December 2019, and net cash paid for the aggregate

1.125% Convertible Notes-related convertible senior notesrelated transactions amountedamounting to $42 million. These cash outflows were partially offset by proceeds of $380 million borrowed under the Term Loan Facility. In the first quarter ofnine months ended September 30, 2019, net cash paid for the aggregate 1.125% Convertible Notes-relatedconvertible senior notes-related transactions amounted to $149$754 million, partially offset by proceeds of $100$220 million borrowed under the Term Loan Facility.term loan facility.

FINANCIAL CONDITION
We believe that our cash resources, borrowing capacity available under ourthe Credit Agreement as discussed further below in “Future Sources and Uses of Liquidity—Future Sources,” and internally generated funds will be sufficient to support our operations, regulatory requirements, debt repayment obligations and capital expenditures for at least the next 12 months.
On a consolidated basis, at March 31,September 30, 2020, our working capital was $2,754$3,397 million, compared with $2,698 million at December 31, 2019. At March 31,September 30, 2020, our cash and investments amounted to $4,457$5,058 million, compared with $4,477 million at December 31, 2019.
Regulatory Capital and Dividend Restrictions
Each of our regulated HMO subsidiaries must maintain a minimum amount of statutory capital determined by statute or regulations. Such statutes, regulations and capital requirements also restrict the timing, payment and amount of dividends and other distributions, loans or advances that may be paid to us as the sole stockholder. To the extent our HMO subsidiaries must comply with these regulations, they may not have the financial flexibility to transfer funds to us. Based upon current statutes and regulations, the minimum capital and surplus (net assets) requirement for these subsidiaries was estimated to be approximately $1,200$1,300 million at March 31,September 30, 2020, compared with $1,110
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$1,110 million at December 31, 2019. Our HMO subsidiaries were in compliance with these minimum capital requirements as of both dates.
Under applicable regulatory requirements, the amount of dividends that may be paid by our HMO subsidiaries without prior approval by regulatory authorities as of March 31,September 30, 2020, is approximately $114$187 million in the aggregate. Our HMO subsidiaries may pay dividends over this amount, but only after approval is granted by the regulatory authorities.
Based on our cash and investments balances as of March 31,September 30, 2020, management believes that its regulated health plan subsidiaries remain well capitalized and exceed their regulatory minimum requirements. We have the ability, and have committed to provide, additional capital to each of our health plans as necessary to ensure compliance with statutory capital and surplus requirements.
Debt Ratings
Our 5.375% Notes and 4.875% Notes areEach of our high-yield senior notes is rated “BB-” by Standard & Poor’s, and “B2”“Ba3” by Moody’s Investor Service, Inc. A downgrade in our ratings could adversely affect our borrowing capacity and increase our borrowing costs.
Financial Covenants
OurThe Credit Agreement contains customary non-financial and financial covenants, including a net leverage ratio and an interest coverage ratio. Such ratios presented below, are computed as defined by the terms of the Credit Agreement. In our 2019 Annual Report on Form 10-K,As of September 30, 2020, we reported thatwere in compliance with all financial and non-financial covenants under the required net leverage ratio was < 4.0x. As a result of the share purchase program described in the Notes to Consolidated Financial Statements, Note 8, “Stockholders' Equity,” such required ratio has changedCredit Agreement and the updated value is presented in the table below.
Credit Agreement Financial CovenantsRequired Per AgreementAs of March 31, 2020
Net leverage ratio< 2.5x1.4x
Interest coverage ratio> 3.5x13.5x
other long-term debt.
In addition, the indentures governing the 4.875% Notes and the 5.375% Noteshigh-yield notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the applicable indenture. As of March 31, 2020, we were in compliance with all covenants under the Credit Agreement and the indentures governing our outstanding notes.
Capital Plan Progress
In the first quarter of 2020, we purchased approximately 3.4 million common shares at an average price of $132.45 per share, amounting to $446 million in the aggregate. In addition, the net cash paid for the aggregate 1.125%

Convertible Notes-related transactions amounted to $42 million, which included repayment of $12 million aggregate principal amount of our 1.125% Convertible Notes and settlement of the remaining respective portions of the related 1.125% Call Option and 1.125% Warrants.
FUTURE SOURCES AND USES OF LIQUIDITY
Future Sources
Our Health Plans segment regulated subsidiaries generate significant cash flows from premium revenue, which is generally received a short time before related healthcare services are paid. Premium revenue is our primary source of liquidity. Thus, any decline in the receipt of premium revenue, and our profitability, could have a negative impact on our liquidity.
Potential Impact of COVID-19 Pandemic. As a resultWe added 625,000 Medicaid members as of September 30, 2020, compared with our Medicaid membership as of March 31, 2020, when we first began to report on the impacts of the surgepandemic. Included in unemploymentthis total are 325,000 members added from our acquisition of the Kentucky Passport business on September 1, 2020. The 47,000 member increase from our acquisition of the New York YourCare business on July 1, 2020, was offset by the decline in membership, in the third quarter of 2020, associated with our announced exit of operations in Puerto Rico. The remaining 300,000 increase in membership was mainly due to the pandemic,suspension of redeterminations, as we expectbelieve that unemployment-related enrollment has not yet materially accessed managed Medicaid. It remains unclear how high the COVID-related membership peak will be, how quickly it will fall as the economy recovers, and where it will ultimately settle. However it does now appear that since unemployment nationally is now just under 8%, the initial industry estimates of unemployment-related Medicaid membership increases were somewhat overstated. On a significant increase in Medicaid eligibility and enrollment. However, due torelated note, the evolving naturedeclaration of the pandemic,extension of the public health emergency period into next year will also likely have an impact. Therefore, we are currently unable to predict the timing or amount of the expected increases in enrollment. Such an increase inIncreased membership would increase our premium revenue, but would also likely result in a significant increase in medical care claims and related costs.
Dividends from Subsidiaries. When available and as permitted by applicable regulations, cash in excess of the capital needs of our regulated health plans is generally paid in the form of dividends to our unregulated parent company to be used for general corporate purposes. As a result of the COVID-19 pandemic, state regulators could restrict the ability of our regulated health plan subsidiaries to pay dividends to the parent company, which would reduce the liquidity of the parent company.
Credit Agreement Borrowing Capacity. As of March 31,September 30, 2020, we had available borrowing capacity of $499 million$1 billion under the revolving credit facility of our Credit Facility.Agreement. In addition, the Credit Agreement provides for a $15 million swingline sub-facility and a $100 million letter of credit sub-facility, as well as incremental term loans available to finance certain acquisitions up to $500 million, plus an unlimited amount of such term loans as long as
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we maintain a minimum consolidated net leverage ratio. See further discussion in the Notes to Consolidated Financial Statements, Note 7, “Debt.8, “Debt.
Commitment Letter. In connection with the MCC acquisition, we entered into a commitment letter on April 30, 2020, pursuant to which, among other things, the lenders have committed to provide us with debt financing in the aggregate principal amount of up to $400 million.
Marketplace Risk Corridor Ruling. On April 27, 2020, the United States Supreme Court issued its opinion in Maine Community Health Options v. United States. The Supreme Court held that §1342 of the Affordable Care Act obligated the federal government to pay participating insurers the full Marketplace risk corridor amounts calculated by that statute, that such payment obligations survived Congress’ appropriations riders, and that impacted insurers may sue the federal government in the U.S. Court of Federal Claims to recover damages for breach of that obligation. There are no distinguishing factors regarding liability or damages between this case and the cases we ourselves have brought against the federal government for its failure to pay our Marketplace risk corridors claims for 2014, 2015, and 2016. We have already obtained summary judgment for our 2014 and 2015 risk corridor claims in the approximate amount of $52 million, and we have brought another claim for approximately $76 million for the government’s failure to pay our 2016 risk corridor claims. The timing of recognition and collection of these outstanding Marketplace risk corridor claims is uncertain, but we will request that the Court of Claims act as expeditiously as possible to enter judgment for all of the risk corridors amounts owed to us.
We believe that our cash resources, borrowing capacity available under our Credit Facility, and internally generated funds will be sufficient to support our operations, regulatory requirements, debt repayment obligations, and capital expenditures for at least the next 12 months.
Future Uses
Potential ImpactCommon Stock Purchases. In September 2020, our board of COVID-19 Pandemic. The pandemic, along withdirectors authorized the related quarantine and social distancing measures, is currently reducing demand for certain routine and non-critical medical services, while at the same time increasing demand for other medical services, such as COVID-19 testing and emergency services. Discretionary utilization could continuepurchase of up to be lower than normal patterns for the second quarter, but then may rebound quickly$500 million, in the second halfaggregate, of 2020 as COVID-19 care abatesour common stock. This program will be funded with cash on hand and health system capacity frees up,extends through December 31, 2021. The exact timing and amount of any repurchase will be determined by management based on market conditions and share price, in addition to other factors, and subject to the current social distancing measures are relaxed over time. Such a surge, asrestrictions relating to which we are presently unable to predict thevolume, price, and timing or magnitude, could result in a significant increase in medical care costs and related provider claims payments. In addition, we expect increased Medicaid enrollment to result in an increase in medical care claims and related costs.under applicable law. No shares were purchased under this program through October 29, 2020.
Also as described above in “Health Plans Segment—Trends and Uncertainties,” the near-term reduced demand is creating financial stress for certain Medicaid providers which may lead state Medicaid agencies to turn to managed care organizations to provide temporary cash advances to impacted providers for insolvency protection.

AcquisitionsOur strategic focus has shifted toWe have a disciplined and steady approach to growth. Organic growth, which includes leveraging our existing health plan portfolio and winning new territories, is our highest priority. In addition to organic growth, we will consider targeted acquisitions that are a strategic fit that we believe will leverage operational synergies, and lead to incremental earnings accretion. For further information on our acquisitions, refer to the Notes to Consolidated Financial Statements, Note 4, “Business Combinations.”
OnIn September 2020, we entered into a definitive agreement to acquire substantially all of the assets of Affinity Health Plan, Inc. The net purchase price for the transaction is approximately $380 million, subject to various adjustments at closing, which we intend to fund with cash on hand. We currently expect the transaction to close as early as the second quarter of 2021.
In September 2020, we completed the acquisition of certain assets of Passport Health Plan, Inc. The estimated total purchase price of $60 million includes our initial cash payment of $20 million in September 2020, plus estimated contingent consideration which consists primarily of an amount due to the seller for members we enroll in the open enrollment period for the 2021 plan year, over a minimum threshold, which resulted in an estimated contingent consideration liability of $40 million. We expect to settle this liability in the first quarter of 2021.
In April 30, 2020, we entered into a definitive agreement to acquire the Magellan Complete Care (“MCC”)MCC line of business of Magellan Health, Inc. The purchase price for the transaction is approximately $820 million, net of certain tax benefits, which we intend to fund with cash on hand. The transaction is subject to federal and state regulatory approvals, and other customary closing conditions, and is expected to close around the end of 2020. In connection with this transaction, Magellan Health, Inc. has agreed to provide certain transition services following the closing.
Outcome of ACA Litigation. As described above in “Health Plans Segment—Trends and Uncertainties,” the U.S. Supreme Court has accepted the appeal of the Fifth Circuit Court’s decision regarding the constitutionality and severability of the individual mandate. The ACA remains in effect pending the issuance of the Supreme Court’s opinion. A decision by the Supreme Court that the entirety of the ACA is unconstitutional could have a material adverse effect on our business, financial condition, cash flows, or results of operations.
Potential Impact of COVID-19 Pandemic. Beginning in early 2020 the pandemic, along with the related quarantine and social distancing measures, initially reduced demand for certain routine and non-critical medical services, while at the same time increased demand for other medical services, such as COVID-19 testing and emergency services. At the beginning of the third quarter of 2020, utilization was still moderately curtailed, but rebounded to more normal levels during the quarter. Increased demand for medical services, which we are presently unable to predict the timing or magnitude, could result in a significant increase in medical care costs and related provider claims payments.
Also, as described above in “Health Plans Segment—Trends and Uncertainties,” we have been subject to Medicaid premium actions as a result of the pandemic. Various states have implemented temporary premium refunds and related actions in response to the reduced demand for medical services stemming from COVID-19, which are resulting in a reduction of our medical margin. In some cases, these premium actions are retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. In the second quarter of 2020, we recognized approximately $75 million for certain of these retroactive premium actions that we believe to be probable, and where the ultimate premium amount is reasonably estimable. In most of those states, the refund period extended into the third quarter of 2020, and one additional state, Michigan, enacted a premium refund mechanism in the firstthird quarter of 2021.2020. Consequently, we recognized an additional $88 million related to these retroactive premium actions in the third quarter of 2020, resulting in $163 million recognized in the nine months ended September 30, 2020.
In October 2019, we entered intoIt is possible that certain states could increase the level of existing premium refunds, and it is also possible that other states could implement some form of retroactive premium refund during the fourth quarter of 2020. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a definitive agreement to acquire certain assetsresult of YourCare Health Plan,changes in facts
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Table of this transaction, expected to occur in mid-2020, we will serve approximately 46,000 Medicaid members in seven counties in western New York. The purchase price will be funded with available cash.Contents
or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows.
Regulatory Capital Requirements and Dividend Restrictions. We have the ability, and have committed to provide, additional capital to each of our health plans as necessary to ensure compliance with statutory capital and surplus requirements.
The Molina Healthcare Charitable Foundation. In August 2020, we announced our commitment of $150 million to fund The Molina Healthcare Charitable Foundation (the “Foundation”), an independent not-for-profit charitable foundation. We intend to make a sizable contribution to the Foundation in the fourth quarter of 2020.

CONTRACTUAL OBLIGATIONS
A summary of future obligations under our various contractual obligations and commitments as of December 31, 2019, was disclosed in our Annual Report on Form 10-K for the year ended December 31, 2019.
Other than the financing transactions described in Notes to Consolidated Financial Statements, Note 7, “Debt,” and Note 11, “Subsequent Events,8, “Debt,” there were no significant changes to this previously filed informationour contractual obligations and commitments outside the ordinary course of business during the first quarter ofnine months ended September 30, 2020.


CRITICAL ACCOUNTING ESTIMATES
When we prepare our consolidated financial statements, we use estimates and assumptions that may affect reported amounts and disclosures; actual results could differ from these estimates. Our critical accounting estimates relate to:
Medical claims and benefits payable. Refer to Notes to Consolidated Financial Statements, Note 6, “Medical Claims and Benefits Payable,” for a table that presents the components of the change in medical claims and benefits payable, and for additional information regarding the factors used to determine our changes in estimates for all periods presented in the accompanying consolidated financial statements. Other than the discussion as noted above, there have been no significant changes during the three months ended March 31,
Medical claims and benefits payable. Refer to Notes to Consolidated Financial Statements, Note 7, “Medical Claims and Benefits Payable,” for a table that presents the components of the change in medical claims and benefits payable, and for additional information regarding the factors used to determine our changes in estimates for all periods presented in the accompanying consolidated financial statements. Other than the discussion as noted above, there have been no significant changes during the nine months ended September 30, 2020, to our disclosure reported in “Critical Accounting Estimates” in our Annual Report on Form 10-K for the year ended December 31, 2019.
Contractual provisions that may adjust or limit revenue or profit. For a discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Notes to Consolidated Financial Statements, Note 2, “Significant Accounting Policies.”
Quality incentives. For a discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Notes to Consolidated Financial Statements, Note 2, “Significant Accounting Policies.”
Goodwill and intangible assets, net. There have been no significant changes, during the three months ended March 31, 2020, to our disclosure reported in “Critical Accounting Estimates” in our Annual Report on Form 10-K for the year ended December 31, 2019.

Contractual provisions that may adjust or limit revenue or profit. For a discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Notes to Consolidated Financial Statements, Note 2, “Significant Accounting Policies.”
Quality incentives. For a discussion of this topic, including amounts recorded in our consolidated financial statements, refer to Notes to Consolidated Financial Statements, Note 2, “Significant Accounting Policies.”
Goodwill and intangible assets, net. There have been no significant changes, during the nine months ended September 30, 2020, to our disclosure reported in “Critical Accounting Estimates” in our Annual Report on Form 10-K for the year ended December 31, 2019.

QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
Our earnings and financial position are exposed to financial market risk relating to changes in interest rates, and the resulting impact on investment income and interest expense.
Substantially all of our investments and restricted investments are subject to interest rate risk and will decrease in value if market interest rates increase. Assuming a hypothetical and immediate 1% increase in market interest rates

at March 31,September 30, 2020, the fair value of our fixed income investments would decrease by approximately $52$42 million. Declines in interest rates over time will reduce our investment income.
For further information on fair value measurements and our investment portfolio, please refer to Notes to Consolidated Financial Statements, Note 4, “Fair5, “Fair Value Measurements,,” and Note 5, “Investments.6, “Investments.
Borrowings under ourthe Credit Agreement bear interest based, at our election, on a base rate or other defined rate, plus in each case, the applicable margin. As of March 31, 2020, $600 million was outstanding under the Term Loan Facility. For further information, see Notes to Consolidated Financial Statements, Note 7, “8, “Debt.”
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Debt.”

CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures. Our management, with the participation of our chief executive officer and our chief financial officer, has concluded, based upon its evaluation as of the end of the period covered by this report, that the Company’s “disclosure controls and procedures” (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act), are effective to ensure that information required to be disclosed in the reports that we file or submit under the Securities Exchange Act is recorded, processed, summarized, and reported within the time periods specified in the SEC’s rules and forms.
Changes in Internal Control Over Financial Reporting. There has been no change in our internal control over financial reporting during the fiscal quarter ended March 31,September 30, 2020, that has materially affected, or is reasonably likely to materially affect, our internal controls over financial reporting.

LEGAL PROCEEDINGS
For information regarding legal proceedings, see Notes to Consolidated Financial Statements, Note 10, “Commitments11, “Commitments and ContingenciesContingencies.”
.”

RISK FACTORS
Certain risks may have a material adverse effect on our business, financial condition, cash flows, results of operations, or stock price, and you should carefully consider them before making an investment decision with respect to our securities. In addition to the other information set forth in this report, you should carefully consider the risk factorfactors set forth below and those discussed under the caption “Risk Factors,” in our Annual Report on Form 10-K10‑K for the year ended December 31, 2019.2019, and in our Quarterly Reports on Form 10-Q for the quarters ended March 31, 2020 and June 30, 2020. The risk factorfactors below, together with those described in our Annual Report on Form 10-K for the year ended December 31, 2019,reports listed above, are not the only risks that we face. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial may also materially adversely affect our business, financial condition, cash flows, results of operations, or stock price.
Our business, financial condition, and results of operations will be impacted by In addition to the risks relating to the COVID-19 pandemic and the extent of such impact cannot be reasonably foreseen at this time.
We currently expect that the COVID-19 pandemic will impact our business, financial condition, cash flows, or results of operations in a number of ways, including the following:
It will have an adverse impact on the health of an indeterminate number of our members in the states in which we operate, resulting in increases in medical care costs associated with those impacted members;
The reduced demand for certain routine and non-critical medical services has created financial stress for certain Medicaid providers and could result inreports listed above, the insolvency of such providers, and/or demands that we make direct payments or loans to them;
It has created, and may continue to create, volatility in the capital markets and such volatility could have a negative impact on our ability to access those markets on acceptable terms, or at all;
State tax revenues may decline significantly, threatening the ability of certain states to continue to make timely monthly capitation payments to us;
We will incur increased costs associated with the measures we are currently implementing and planning to implement to mitigate the implicationseffects of the COVID-19 pandemic and to transfer our workforce to work-from-home status; and

It may impactalso have the abilityeffect of our outsourced information technology service providers, and other third-party vendors, to perform contracted services.
Due to the uncertainty around the duration and breadthsignificantly heightening many of the COVID-19 pandemic, the ultimate impact on our business, financial condition, and operating results cannot be reasonably estimated at this time.
There are numerousother risks associated with our intended acquisitionbusiness.
The May 2020 contract award to our Kentucky Medicaid plan is the subject of Magellan Complete Care.a legal challenge.
On AprilOctober 23, 2020, pursuant to the appeal of a protest denial with regard to the May 2020 Kentucky RFP awards, a court ordered the addition of a sixth health plan to the Kentucky Medicaid program for 2021. That ruling did not rescind the Medicaid contract award to our Kentucky health plan for 2021, nor did it impact the earlier novation of the Passport Medicaid contract to us. On October 27, 2020, a different health plan filed an appeal with regard to the court’s October 23rd order. The outcome of litigation and appellate proceedings is inherently unpredictable. In the event the contract award to our Kentucky health plan or the novation of the Passport Medicaid contract is challenged or overturned, the business and revenues of our Kentucky health plan may be materially affected.
Molina Healthcare, Inc. September 30, 2020 we entered into a definitive agreement to acquire the Magellan Complete Care (“MCC”) lineForm 10-Q | 43

Table of business of Magellan Health, Inc. MCC is a managed care organization serving members in the six states of Arizona, Florida, Massachusetts, New York, Virginia, and Wisconsin. The transaction is subject to federal and state regulatory approvals, and other customary closing conditions. In connection with this transaction, Magellan Health, Inc. has agreed to provide to us certain transition services following the closing. Contents
There are numerous risks associated with the intended transaction, including but not limited to the risk that: (i) state or federal regulatory approvals may be delayed or not obtained, or are obtained subject to conditions that are not anticipated; (ii) the transition services Magellan Health has agreed to provide following the closing are not provided in a timely or efficient manner or that certain necessary transition services are not provided at all; (iii) there is attrition in MMC membership pending the completion of the proposed transaction; (iv) Molina is unable to successfully retain or integrate the employees and operations of MCC, including issues related to disparate claims processing and record-keeping systems and difficulties integrating the acquired businesses on our own information technology platforms; (v) Molina is unable to maintain MCC provider relations or experiences medical cost increases resulting from unfavorable changes in contracting or re-contracting with providers; (vi) disruption results from the announcement or pendency of the transaction, including potential adverse reactions by customers, employees, suppliers, regulators, or federal or state legislators, making it more difficult to maintain business and operational relationships; (vii) expected synergies from the transaction are not realized to the extent expected or within the expected time period; and (viii) unexpected costs are incurred in connection with the completion and/or integration of MCC. In addition, there are numerous risk and uncertainties associated with the COVID-19 pandemic, including the duration and scope of its impact on the benefits Molina expects to realize from the transaction, which impact Molina cannot reasonably estimate at this time. The realization of any of the foregoing risks could have an adverse effect on our business, financial condition, cash flows, or results of operations.

UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS
ISSUER PURCHASES OF EQUITY SECURITIES
Purchases of common stock made by us, or on our behalf during the quarter ended March 31,September 30, 2020, including shares withheld by us to satisfy our employees’ income tax obligations, are set forth below:
 
Total Number
of Shares
Purchased (1)
 
Average Price 
Paid per Share
 
Total Number of Shares
Purchased as Part of
Publicly 
Announced 
Plans or
Programs
 
Approximate 
Dollar Value
of Shares that May Yet Be Purchased Under the Plans or Programs
January 1 - January 31980
 $143.27
 1,190,088
 $286,000,000
February 1 - February 29
 $
 1,015,529
 $153,000,000
March 1 - March 3159,947
 $122.55
 1,161,066
 $
Total60,927
 $122.88
 3,366,683
  
Total Number
of Shares
Purchased (1)
Average Price Paid per ShareTotal Number of Shares
Purchased as Part of
Publicly 
Announced 
Plans or
Programs
Approximate 
Dollar Value
of Shares that May Yet Be Purchased Under the Plans or Programs (2)
July 1 - July 31821 $179.12 — $— 
August 1 - August 31— $— — $— 
September 1 - September 30— $— — $500,000,000 
Total821 $— — 
_______________________
(1)During the three months ended March 31, 2020, we withheld 60,927 shares of common stock, to settle employee income tax obligations, for releases of awards granted under the Molina Healthcare, Inc. 2019 Equity Incentive Plan. For further information refer to Note 8, “Stockholders' Equity.”

(1)During the three months ended September 30, 2020, we withheld 821 shares of common stock, to settle employee income tax obligations, for releases of awards granted under the Molina Healthcare, Inc. 2019 Equity Incentive Plan. For further information refer to Note 9, “Stockholders' Equity.”
(2)In September 2020, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This program will be funded with cash on hand and extends through December 31, 2021. The exact timing and amount of any repurchase will be determined by management based on market conditions and share price, in addition to other factors, and subject to the restrictions relating to volume, price, and timing under applicable law. No shares were purchased under this program through October 29, 2020.
Molina Healthcare, Inc. September 30, 2020 Form 10-Q | 44

INDEX TO EXHIBITS 
Exhibit No.TitleMethod of Filing
Asset Purchase Agreement, dated as of September 28, 2020, by and between Molina Healthcare, Inc. and Affinity Health Plan, Inc.*Filed herewith.
Exhibit No.TitleMethod of Filing
Certificate of Incorporation.*Filed as Exhibit 3.2 to registrant’s Registration Statement on Form S-1 filed December 30, 2002
Section 302 Certification of Chief Executive OfficerFiled herewith.
Section 302 Certification of Chief Financial OfficerFiled herewith.
Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.Filed herewith.
Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.Filed herewith.
101.INS XBRL Taxonomy Instance Document.Filed herewith.
101.SCH XBRL Taxonomy Extension Schema Document.Filed herewith.
101.CAL XBRL Taxonomy Extension Calculation Linkbase Document.Filed herewith.
101.DEF XBRL Taxonomy Extension Definition Linkbase Document.Filed herewith.
101.LAB XBRL Taxonomy Extension Label Linkbase Document.Filed herewith.
101.PREXBRL Taxonomy Extension Presentation Linkbase DocumentFiled herewith.
104Cover Page Interactive Data file (formatted as Inline XBRL and embedded within Exhibit 101)Filed herewith.

*Certain portions of this agreement have been omitted in accordance with Item 601(b)(10) of Regulation S-K. A copy of any omitted portion will be furnished to the Securities and Exchange Commission upon request.
*The Certificate
Molina Healthcare, Inc. September 30, 2020 Form 10-Q | 45

Table of Incorporation is being re-filed at this time to reset the link to this exhibit to the relevant SEC filing included with the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2019.Contents



SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
MOLINA HEALTHCARE, INC.
(Registrant)
Dated:May 1,October 29, 2020/s/ JOSEPH M. ZUBRETSKY
Joseph M. Zubretsky
Chief Executive Officer
(Principal Executive Officer)
Dated:May 1,October 29, 2020/s/ THOMAS L. TRAN
Thomas L. Tran
Chief Financial Officer and Treasurer
(Principal Financial Officer)


Molina Healthcare, Inc. March 31,September 30, 2020 Form 10-Q | 4246