Cover Page
Cover Page - shares shares in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Apr. 21, 2023 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2023 | |
Document Transition Report | false | |
Entity File Number | 001-31719 | |
Entity Registrant Name | MOLINA HEALTHCARE, INC. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 13-4204626 | |
Entity Address, Address Line One | 200 Oceangate | |
Entity Address, Address Line Two | Suite 100 | |
Entity Address, City or Town | Long Beach, | |
Entity Address, State or Province | CA | |
Entity Address, Postal Zip Code | 90802 | |
City Area Code | 562 | |
Local Phone Number | 435-3666 | |
Title of 12(b) Security | Common Stock, $0.001 Par Value | |
Trading Symbol | MOH | |
Security Exchange Name | NYSE | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Large Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 58,300 | |
Entity Central Index Key | 0001179929 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2023 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false |
CONSOLIDATED STATEMENTS OF INCO
CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Revenue: | ||
Premium revenue | $ 7,885 | $ 7,531 |
Premium tax revenue | 172 | 208 |
Investment income | 71 | 11 |
Other revenue | 21 | 20 |
Total revenue | 8,149 | 7,770 |
Operating expenses: | ||
Medical care costs | 6,871 | 6,563 |
General and administrative expenses | 591 | 571 |
Premium tax expenses | 172 | 208 |
Depreciation and amortization | 44 | 40 |
Other | 16 | 16 |
Total operating expenses | 7,694 | 7,398 |
Operating income | 455 | 372 |
Other expenses, net: | ||
Interest expense | 28 | 28 |
Total other expenses, net | 28 | 28 |
Income before income tax expense | 427 | 344 |
Income tax expense | 106 | 86 |
Net income | $ 321 | $ 258 |
Net income per share: | ||
Net income per share - Basic (in dollars per share) | $ 5.58 | $ 4.45 |
Net income per share - Diluted (in dollars per share) | $ 5.52 | $ 4.39 |
CONSOLIDATED STATEMENTS OF COMP
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Statement of Comprehensive Income [Abstract] | ||
Net income | $ 321 | $ 258 |
Other comprehensive gain (loss): | ||
Unrealized investment gain (loss) | 46 | (100) |
Less: effect of income taxes | 11 | (24) |
Other comprehensive gain (loss), net of tax | 35 | (76) |
Comprehensive income | $ 356 | $ 182 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Current assets: | ||
Cash and cash equivalents | $ 4,554 | $ 4,006 |
Investments | 3,810 | 3,499 |
Receivables | 2,536 | 2,302 |
Prepaid expenses and other current assets | 259 | 277 |
Total current assets | 11,159 | 10,084 |
Property, equipment, and capitalized software, net | 274 | 259 |
Goodwill, and intangible assets, net | 1,369 | 1,390 |
Restricted investments | 242 | 238 |
Deferred income taxes | 208 | 220 |
Other assets | 119 | 123 |
Total assets | 13,371 | 12,314 |
Current liabilities: | ||
Medical claims and benefits payable | 3,824 | 3,528 |
Amounts due government agencies | 2,349 | 2,079 |
Accounts payable, accrued liabilities and other | 787 | 889 |
Deferred revenue | 654 | 359 |
Total current liabilities | 7,614 | 6,855 |
Long-term debt | 2,177 | 2,176 |
Finance lease liabilities | 204 | 215 |
Other long-term liabilities | 88 | 104 |
Total liabilities | 10,083 | 9,350 |
Stockholders’ equity: | ||
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 58 million shares at March 31, 2023 and December 31, 2022 | 0 | 0 |
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding | 0 | 0 |
Additional paid-in capital | 296 | 328 |
Accumulated other comprehensive loss | (125) | (160) |
Retained earnings | 3,117 | 2,796 |
Total stockholders’ equity | 3,288 | 2,964 |
Total liabilities and stockholders’ equity | $ 13,371 | $ 12,314 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Mar. 31, 2023 | Dec. 31, 2022 |
Statement of Financial Position [Abstract] | ||
Common stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 150,000,000 | 150,000,000 |
Common stock, shares outstanding (in shares) | 58,000,000 | 58,000,000 |
Preferred stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized (in shares) | 20,000,000 | 20,000,000 |
Preferred stock, shares issued (in shares) | 0 | 0 |
Preferred stock, shares outstanding (in shares) | 0 | 0 |
CONSOLIDATED STATEMENTS OF STOC
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions | Total | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive (Loss) Income | Retained Earnings |
Beginning balance (in shares) at Dec. 31, 2021 | 58 | ||||
Beginning balance at Dec. 31, 2021 | $ 2,630 | $ 0 | $ 236 | $ (5) | $ 2,399 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 258 | 258 | |||
Other comprehensive income, net | (76) | (76) | |||
Share-based compensation (in shares) | 1 | ||||
Share-based compensation | (18) | (18) | |||
Ending balance (in shares) at Mar. 31, 2022 | 59 | ||||
Ending balance at Mar. 31, 2022 | 2,794 | $ 0 | 218 | (81) | 2,657 |
Beginning balance (in shares) at Dec. 31, 2022 | 58 | ||||
Beginning balance at Dec. 31, 2022 | 2,964 | $ 0 | 328 | (160) | 2,796 |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||
Net income | 321 | 321 | |||
Other comprehensive income, net | 35 | 35 | |||
Share-based compensation | (32) | (32) | |||
Ending balance (in shares) at Mar. 31, 2023 | 58 | ||||
Ending balance at Mar. 31, 2023 | $ 3,288 | $ 0 | $ 296 | $ (125) | $ 3,117 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Operating activities: | ||
Net income | $ 321 | $ 258 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 44 | 40 |
Deferred income taxes | 1 | 16 |
Share-based compensation | 25 | 34 |
Other, net | 5 | (8) |
Changes in operating assets and liabilities: | ||
Receivables | (234) | 21 |
Prepaid expenses and other current assets | 7 | (32) |
Medical claims and benefits payable | 296 | 263 |
Amounts due government agencies | 270 | 137 |
Accounts payable, accrued liabilities and other | (215) | (81) |
Deferred revenue | 295 | (352) |
Income taxes | 101 | 67 |
Net cash provided by operating activities | 916 | 363 |
Investing activities: | ||
Purchases of investments | (646) | (403) |
Proceeds from sales and maturities of investments | 371 | 513 |
Purchases of property, equipment and capitalized software | (32) | (23) |
Other, net | 5 | (13) |
Net cash (used in) provided by investing activities | (302) | 74 |
Financing activities: | ||
Common stock withheld to settle employee tax obligations | (58) | (52) |
Contingent consideration liabilities settled | 0 | (20) |
Other, net | (7) | (5) |
Net cash used in financing activities | (65) | (77) |
Net increase in cash, cash equivalents, and restricted cash and cash equivalents | 549 | 360 |
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period | 4,048 | 4,506 |
Cash, cash equivalents, and restricted cash and cash equivalents at end of period | $ 4,597 | $ 4,866 |
Organization and Basis of Prese
Organization and Basis of Presentation | 3 Months Ended |
Mar. 31, 2023 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization and Basis of Presentation | 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 four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. As of March 31, 2023, we served approximately 5.3 million members eligible for government-sponsored healthcare programs, located across 19 states. Our state Medicaid contracts typically have terms of three 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 (“ABD”); and regions or service areas. In Medicare, we enter into Medicare Advantage-Part D contracts with the Centers for Medicare and Medicaid Services (“CMS”) annually, and for dual-eligible plans, we enter into contracts with CMS, in partnership with each state’s department of health and human services. Such contracts typically have terms of one In Marketplace, we enter into contracts with CMS, which end on December 31 of each year, and must be renewed annually. Recent Developments Indiana Procurement—Medicaid. In March 2023, we announced that the Indiana Department of Administration has recommended that contract negotiations begin with our Indiana health plan. Under the proposed contract with the Indiana Family and Social Services Administration (“FSSA”), we are expected to provide risk-based managed care long term services and supports as part of the Indiana Pathways for Aging LTSS program pursuant to the request for proposal issued by FSSA in February 2022. The new contract is expected to have an initial four-year term, with the potential for two one-year renewal terms. Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, these financial statements reflect all normal recurring adjustments, which are considered necessary for a fair presentation of the results as of the dates and for the interim periods presented. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the three months ended March 31, 2023 are not necessarily indicative of the results for the entire year ending December 31, 2023. 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, 2022. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2022, 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, 2022. Use of Estimates |
Significant Accounting Policies
Significant Accounting Policies | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Significant Accounting Policies | 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 of cash and 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. March 31, 2023 2022 (In millions) Cash and cash equivalents $ 4,554 $ 4,804 Restricted cash and cash equivalents 43 62 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,597 $ 4,866 Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made. March 31, December 31, (In millions) Government receivables $ 1,896 $ 1,702 Pharmacy rebate receivables 275 291 Other 365 309 Total $ 2,536 $ 2,302 Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the 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 premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates, including certain components of premium revenue that are subject to accounting estimates and are described below, and in our 2022 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.” Contractual Provisions That May Adjust or Limit Revenue or Profit 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 reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets. Categorized by program, such amounts due government agencies included the following: March 31, December 31, (In millions) Medicaid program: Minimum MLR, corridors, and profit sharing $ 1,302 $ 1,145 Other premium adjustments 557 482 Medicare program: Minimum MLR and profit sharing 85 84 Risk adjustment and Part D risk sharing 61 76 Other premium adjustments 27 27 Marketplace program: Risk adjustment 278 230 Minimum MLR 1 2 Other premium adjustments 38 33 Total amounts due government agencies $ 2,349 $ 2,079 Medicaid Program 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 as a percentage of premium revenue, or minimum medical loss ratio (“Minimum MLR”). Under certain medical cost corridor provisions, the health plans may refund premiums or receive additional premiums, depending on whether amounts spent on medical care costs fall below or exceed defined thresholds. This includes remaining risk corridors that were enacted by various states in 2020 in response to the reduced demand for medical services stemming from COVID-19. Profit Sharing. Our contracts with certain states contain profit sharing 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. Other Premium Adjustments. State Medicaid programs periodically adjust premium revenues on a retroactive basis for rate changes and changes in membership and eligibility data. In certain states, adjustments are made based on the health status of our members (as measured through a risk score). In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Marketplace Program 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 for all plan participants in a state (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score for all plan participants in a state (risk adjustment receivable). Under CMS rules, the Marketplace risk adjustment pool is budget neutral. We estimate our ultimate premium based on insurance policy year-to-date experience, and the data submitted and expected to be submitted to CMS, 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, 2023, Marketplace risk adjustment estimated payables amounted to $278 million and estimated receivables amounted to $173 million, for a net payable of $105 million. As of December 31, 2022, Marketplace risk adjustment estimated payables amounted to $230 million and estimated receivables amounted to $135 million, for a net payable of $95 million. 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 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, U.S. Treasury securities, and corporate debt 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 in which our health plan subsidiaries operate. 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, and nondeductible expenses such as 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 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. |
Net Income Per Share
Net Income Per Share | 3 Months Ended |
Mar. 31, 2023 | |
Earnings Per Share [Abstract] | |
Net Income Per Share | Net Income Per Share The following table sets forth the calculation of basic and diluted net income per share: Three Months Ended March 31, 2023 2022 (In millions, except net income per share) Numerator: Net income $ 321 $ 258 Denominator: Shares outstanding at the beginning of the period 57.4 57.9 Weighted-average number of shares issued: Stock-based compensation 0.1 0.1 Denominator for basic net income per share 57.5 58.0 Effect of dilutive securities: (1) Stock-based compensation 0.5 0.7 Denominator for diluted net income per share 58.0 58.7 Net income per share - Basic (2) $ 5.58 $ 4.45 Net income per share - Diluted (2) $ 5.52 $ 4.39 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. (2) Source data for calculations in thousands. |
Fair Value Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2023 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Fair Value Measurements We consider the carrying amounts of current assets and current liabilities 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 used to: a) estimate the fair value; and b) determine the classification according to the fair value hierarchy for each financial instrument, refer to our 2022 Annual Report on Form 10-K, Note 5, “Fair Value Measurements.” Our financial instruments measured at fair value on a recurring basis at March 31, 2023, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,335 $ — $ 2,335 $ — Mortgage-backed securities 851 — 851 — Asset-backed securities 323 — 323 — Municipal securities 151 — 151 — U.S. Treasury notes 123 — 123 — Other 27 — 27 — Total assets $ 3,810 $ — $ 3,810 $ — Our financial instruments measured at fair value on a recurring basis at December 31, 2022, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,184 $ — $ 2,184 $ — Mortgage-backed securities 731 — 731 — Asset-backed securities 288 — 288 — Municipal securities 149 — 149 — U.S. Treasury notes 105 — 105 — Other 42 — 42 — Total assets $ 3,499 $ — $ 3,499 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8 Contingent Consideration Liabilities In the three months ended March 31, 2023, we paid $8 million in connection with our 2020 acquisition of certain assets of Passport Health Plan, Inc., which represented the final payment of the consideration due relating to an operating income guarantee. The amount paid in the three months ended March 31, 2023, has been presented in “Operating activities” in the accompanying consolidated statements of cash flows. 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. March 31, 2023 December 31, 2022 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 793 $ 742 $ 792 $ 729 3.875% Notes due 2030 643 568 643 554 3.875% Notes due 2032 741 637 741 629 Total $ 2,177 $ 1,947 $ 2,176 $ 1,912 |
Investments
Investments | 3 Months Ended |
Mar. 31, 2023 | |
Investments, Debt and Equity Securities [Abstract] | |
Investments | Investments Available-for-Sale We consider all of our investments classified as current assets to be available-for-sale. The following tables summarize our current investments as of the dates indicated: March 31, 2023 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,428 $ 6 $ 99 $ 2,335 Mortgage-backed securities 897 2 48 851 Asset-backed securities 337 — 14 323 Municipal securities 160 — 9 151 U.S. Treasury notes 123 — — 123 Other 29 — 2 27 Total $ 3,974 $ 8 $ 172 $ 3,810 December 31, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,303 $ 2 $ 121 $ 2,184 Mortgage-backed securities 787 — 56 731 Asset-backed securities 308 — 20 288 Municipal securities 160 — 11 149 U.S. Treasury notes 106 — 1 105 Other 45 — 3 42 Total $ 3,709 $ 2 $ 212 $ 3,499 The contractual maturities of our current investments as of March 31, 2023 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 280 $ 277 Due after one year through five years 2,340 2,245 Due after five years through ten years 455 443 Due after ten years 899 845 Total $ 3,974 $ 3,810 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 were insignificant for the three months ended March 31, 2023, and 2022. Gross realized investments losses amounted to $10 million in the three months ended March 31, 2023, and were reclassified into earnings from other comprehensive income on a net-of-tax basis. Gross realized investment losses were insignificant in the three months ended March 31, 2022. We have determined that unrealized losses at March 31, 2023, and December 31, 2022, primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we determined that an allowance for credit losses was 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, and those that have been in a continuous loss position for 12 months or more as of March 31, 2023: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 719 $ 15 480 $ 1,107 $ 84 510 Mortgage-backed securities 257 6 144 467 42 228 Asset-backed securities 134 2 76 133 12 73 Municipal securities 48 1 28 83 8 105 Other 8 1 9 10 1 7 Total $ 1,166 $ 25 737 $ 1,800 $ 147 923 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 months or more as of December 31, 2022: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,124 $ 45 683 $ 887 $ 76 371 Mortgage-backed securities 395 20 220 319 36 131 Asset-backed securities 161 6 108 118 14 59 Municipal securities 75 4 83 57 7 57 U.S. Treasury notes 88 1 6 — — — Other 15 1 16 17 2 6 Total $ 1,858 $ 77 1,116 $ 1,398 $ 135 624 Restricted Investments Held-to-Maturity Pursuant to the regulations governing our state health plan subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, U.S. Treasury securities, and corporate debt 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 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 $242 million at March 31, 2023, of which $123 million will mature in one year or less, $111 million will mature in one through five years, and $8 million will mature after five years. |
Medical Claims and Benefits Pay
Medical Claims and Benefits Payable | 3 Months Ended |
Mar. 31, 2023 | |
Other Liabilities Disclosure [Abstract] | |
Medical Claims and Benefits Payable | Medical Claims and Benefits Payable The following table provides the details of our medical claims and benefits payable as of the dates indicated: March 31, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,589 $ 2,597 Pharmacy payable 233 206 Capitation payable 95 94 Other 907 631 Total $ 3,824 $ 3,528 “Other” medical claims and benefits payable include 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 $493 million and $228 million as of March 31, 2023, and December 31, 2022, respectively. The following tables present 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 years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported. Three Months Ended March 31, 2023 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,815 $ 452 $ 261 $ 3,528 Components of medical care costs related to: Current year 5,865 934 370 7,169 Prior years (250) (14) (34) (298) Total medical care costs 5,615 920 336 6,871 Payments for medical care costs related to: Current year 3,728 542 217 4,487 Prior years 1,822 369 167 2,358 Total paid 5,550 911 384 6,845 Acquired balances, net of post-acquisition adjustments — — — — Change in non-risk and other provider payables 270 — — 270 Medical claims and benefits payable, ending balance $ 3,150 $ 461 $ 213 $ 3,824 Three Months Ended March 31, 2022 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,580 $ 404 $ 379 $ 3,363 Components of medical care costs related to: Current year 5,424 840 505 6,769 Prior years (154) (25) (27) (206) Total medical care costs 5,270 815 478 6,563 Payments for medical care costs related to: Current year 3,402 465 330 4,197 Prior years 1,633 306 260 2,199 Total paid 5,035 771 590 6,396 Acquired balances, net of post-acquisition adjustments (25) — — (25) Change in non-risk and other provider payables 93 3 — 96 Medical claims and benefits payable, ending balance $ 2,883 $ 451 $ 267 $ 3,601 Our estimates of medical claims and benefits payable recorded at December 31, 2022, and 2021 developed favorably by approximately $298 million and $206 million as of March 31, 2023, and 2022, respectively. The favorable prior year development recognized in the three months ended March 31, 2023 was primarily due to lower than expected utilization of medical services by our members and improved operating performance. Consequently, the ultimate costs recognized in 2023, as claims payments were processed, were lower than our estimates in 2022. |
Debt
Debt | 3 Months Ended |
Mar. 31, 2023 | |
Debt Disclosure [Abstract] | |
Debt | Debt The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: March 31, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 3.875% Notes due 2030 650 650 3.875% Notes due 2032 750 750 Deferred debt issuance costs (23) (24) Total $ 2,177 $ 2,176 Credit Agreement We are party to a credit agreement (the “Credit Agreement”) which includes a revolving credit facility (“Credit Facility”) of $1.0 billion, among other 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. Effective April 26, 2023, we amended the Credit Agreement to transition from the use of the London Interbank Offered Rate, or LIBOR, to the Secured Overnight Financing Rate, or SOFR, as a benchmark interest rate used in the Credit Agreement. We have other relationships, including financial advisory and banking, with some parties to the Credit Agreement. The Credit Agreement contains customary non-financial and financial covenants. As of March 31, 2023, we were in compliance with all financial and non-financial covenants under the Credit Agreement. As of March 31, 2023, no amounts were outstanding under the Credit Facility. For an understanding of the terms and provisions of the Credit Agreement, reference should be made to the copy of the agreement attached as Exhibit 10.1 to this Form 10-Q and incorporated by reference herein. Senior Notes Our senior notes are described below. Each of these notes are senior unsecured obligations of the parent corporation, Molina Healthcare, Inc., and rank equally in right of payment with all existing and future senior debt, and senior to all existing and future subordinated debt of Molina Healthcare, Inc. In addition, each of the indentures governing the senior notes contain customary non-financial covenants and change of control provisions. As of March 31, 2023, we were in compliance with all non-financial covenants in the indentures governing the senior notes. The indentures governing the 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. We had $800 million aggregate principal amount of senior notes (the “4.375% Notes”) outstanding as of March 31, 2023, which are due June 15, 2028, unless earlier redeemed. Interest, at a rate of 4.375% per annum, is payable semiannually in arrears on June 15 and December 15. 3.875% Notes due 2030. We had $650 million aggregate principal amount of senior notes (the “3.875% Notes due 2030”) outstanding as of March 31, 2023, which are due November 15, 2030, unless earlier redeemed. Interest, at a rate of 3.875% per annum, is payable semiannually in arrears on May 15 and November 15. |
Segments
Segments | 3 Months Ended |
Mar. 31, 2023 | |
Segment Reporting [Abstract] | |
Segments | Segments We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes long-term services and supports consultative services in Wisconsin. The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and medical care ratio (“MCR”). MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying medical margin, or the amount earned by the Medicaid, Medicare, and Marketplace segments after medical costs are deducted from premium revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer to review results, assess performance, and allocate resources. The key metric used to assess the performance of our Other segment is service margin. The service margin is equal to service revenue minus cost of service revenue. We do not report total assets by segment because this is not a metric used to assess segment performance or allocate resources. The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended March 31, 2023 2022 (In millions) Total revenue: Medicaid $ 6,578 $ 6,187 Medicare 1,056 949 Marketplace 497 616 Other 18 18 Total $ 8,149 $ 7,770 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended March 31, 2023 2022 (In millions) Margin: Medicaid $ 734 $ 710 Medicare 126 128 Marketplace 154 130 Other 2 3 Total margin 1,016 971 Add: other operating revenues (1) 246 221 Less: other operating expenses (2) (807) (820) Operating income 455 372 Other expenses, net 28 28 Income before income tax expense $ 427 $ 344 ______________________ (1) Other operating revenues include premium tax revenue, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses. |
Commitments and Contingencies
Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2023 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | Commitments and Contingencies Legal Proceedings The healthcare industry is subject to numerous laws and regulations of federal, state, and local governments. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. Penalties associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, the repayment of previously billed and collected revenues and reputational damage. We are involved in legal actions in the ordinary course of business including, but not limited to, various employment claims, vendor disputes and provider claims. Some of these legal actions seek monetary damages, including claims for punitive damages, which may not be covered by insurance. We review legal matters and update our estimates of reasonably possible losses and related disclosures, as necessary. We have accrued liabilities for legal matters for which we deem the loss to be both probable and reasonably estimable. These liability estimates could change as a result of further developments of the matters. The outcome of legal actions is inherently uncertain. 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. Kentucky RFP . On September 4, 2020, Anthem Kentucky Managed Care Plan, Inc. brought an action in Franklin County Circuit Court against the Kentucky Finance and Administration Cabinet, the Kentucky Cabinet for Health and Family Services, and all of the five winning bidder health plans, including our Kentucky health plan. On September 9, 2022, the Kentucky Court of Appeals ruled that, with regard to the earlier Circuit Court ruling granting Anthem relief, the Circuit Court should not have invalidated the 2020 procurement and thus should not have awarded a contract to Anthem. Anthem sought discretionary review by the Kentucky Supreme Court of the ruling by the Court of Appeals. On April 19, 2023, the Kentucky Supreme Court granted Anthem’s request for discretionary review and ordered legal briefing. Pending further Court order, our Kentucky health plan will continue to operate for the foreseeable future under its current Medicaid contract. Puerto Rico. On August 13, 2021, Molina Healthcare of Puerto Rico, Inc. (“MHPR”) filed a complaint with the Commonwealth of Puerto Rico, Court of First Instance, San Juan (State Court) asserting, among other claims, breach of contract against Puerto Rico Health Insurance Administration (“ASES”). On September 13, 2021, ASES filed a counterclaim and a third-party complaint against MHPR and the Company. This matter remains subject to significant additional proceedings, and no prediction can be made as to the outcome. |
Significant Accounting Polici_2
Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Consolidation and Interim Financial Information | Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, these financial statements reflect all normal recurring adjustments, which are considered necessary for a fair presentation of the results as of the dates and for the interim periods presented. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the three months ended March 31, 2023 are not necessarily indicative of the results for the entire year ending December 31, 2023. |
Use of Estimates | Use of EstimatesThe 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. |
Cash and Cash Equivalents | Cash and Cash EquivalentsCash 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. |
Receivables | Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made. |
Premium Revenue Recognition and Amounts Due Government Agencies and Contractual Provisions That May Adjust or Limit Revenue or Profit | Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the 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 premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates, including certain components of premium revenue that are subject to accounting estimates and are described below, and in our 2022 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.” Medicaid Program 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 as a percentage of premium revenue, or minimum medical loss ratio (“Minimum MLR”). Under certain medical cost corridor provisions, the health plans may refund premiums or receive additional premiums, depending on whether amounts spent on medical care costs fall below or exceed defined thresholds. This includes remaining risk corridors that were enacted by various states in 2020 in response to the reduced demand for medical services stemming from COVID-19. |
Concentrations of Credit Risk | 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 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, U.S. Treasury securities, and corporate debt 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 in which our health plan subsidiaries operate. |
Income Taxes | 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, and nondeductible expenses such as 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 | Recent Accounting Pronouncements 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. |
Significant Accounting Polici_3
Significant Accounting Policies (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Schedule of Cash and Cash Equivalents | The following table provides a reconciliation of cash and 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. March 31, 2023 2022 (In millions) Cash and cash equivalents $ 4,554 $ 4,804 Restricted cash and cash equivalents 43 62 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,597 $ 4,866 |
Schedule of Restricted Cash and Cash Equivalents | The following table provides a reconciliation of cash and 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. March 31, 2023 2022 (In millions) Cash and cash equivalents $ 4,554 $ 4,804 Restricted cash and cash equivalents 43 62 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,597 $ 4,866 |
Schedule of Receivables | March 31, December 31, (In millions) Government receivables $ 1,896 $ 1,702 Pharmacy rebate receivables 275 291 Other 365 309 Total $ 2,536 $ 2,302 |
Schedule of Amounts Due to Government Agencies | Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets. Categorized by program, such amounts due government agencies included the following: March 31, December 31, (In millions) Medicaid program: Minimum MLR, corridors, and profit sharing $ 1,302 $ 1,145 Other premium adjustments 557 482 Medicare program: Minimum MLR and profit sharing 85 84 Risk adjustment and Part D risk sharing 61 76 Other premium adjustments 27 27 Marketplace program: Risk adjustment 278 230 Minimum MLR 1 2 Other premium adjustments 38 33 Total amounts due government agencies $ 2,349 $ 2,079 |
Net Income Per Share (Tables)
Net Income Per Share (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Earnings Per Share [Abstract] | |
Schedule of Denominators for The Computation of Basic and Diluted Earnings Per Share | The following table sets forth the calculation of basic and diluted net income per share: Three Months Ended March 31, 2023 2022 (In millions, except net income per share) Numerator: Net income $ 321 $ 258 Denominator: Shares outstanding at the beginning of the period 57.4 57.9 Weighted-average number of shares issued: Stock-based compensation 0.1 0.1 Denominator for basic net income per share 57.5 58.0 Effect of dilutive securities: (1) Stock-based compensation 0.5 0.7 Denominator for diluted net income per share 58.0 58.7 Net income per share - Basic (2) $ 5.58 $ 4.45 Net income per share - Diluted (2) $ 5.52 $ 4.39 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. (2) Source data for calculations in thousands. |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Fair Value Disclosures [Abstract] | |
Schedule of Fair Value of Assets Measured on Recurring Basis | Our financial instruments measured at fair value on a recurring basis at March 31, 2023, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,335 $ — $ 2,335 $ — Mortgage-backed securities 851 — 851 — Asset-backed securities 323 — 323 — Municipal securities 151 — 151 — U.S. Treasury notes 123 — 123 — Other 27 — 27 — Total assets $ 3,810 $ — $ 3,810 $ — Our financial instruments measured at fair value on a recurring basis at December 31, 2022, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,184 $ — $ 2,184 $ — Mortgage-backed securities 731 — 731 — Asset-backed securities 288 — 288 — Municipal securities 149 — 149 — U.S. Treasury notes 105 — 105 — Other 42 — 42 — Total assets $ 3,499 $ — $ 3,499 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8 |
Schedule of Fair Value Measurements of Senior Notes | March 31, 2023 December 31, 2022 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 793 $ 742 $ 792 $ 729 3.875% Notes due 2030 643 568 643 554 3.875% Notes due 2032 741 637 741 629 Total $ 2,177 $ 1,947 $ 2,176 $ 1,912 |
Investments (Tables)
Investments (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Investments, Debt and Equity Securities [Abstract] | |
Schedule of Investments | The following tables summarize our current investments as of the dates indicated: March 31, 2023 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,428 $ 6 $ 99 $ 2,335 Mortgage-backed securities 897 2 48 851 Asset-backed securities 337 — 14 323 Municipal securities 160 — 9 151 U.S. Treasury notes 123 — — 123 Other 29 — 2 27 Total $ 3,974 $ 8 $ 172 $ 3,810 December 31, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,303 $ 2 $ 121 $ 2,184 Mortgage-backed securities 787 — 56 731 Asset-backed securities 308 — 20 288 Municipal securities 160 — 11 149 U.S. Treasury notes 106 — 1 105 Other 45 — 3 42 Total $ 3,709 $ 2 $ 212 $ 3,499 |
Schedule of Contractual Maturities of Investments | The contractual maturities of our current investments as of March 31, 2023 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 280 $ 277 Due after one year through five years 2,340 2,245 Due after five years through ten years 455 443 Due after ten years 899 845 Total $ 3,974 $ 3,810 |
Schedule of Available-for-Sale Investments | 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 months or more as of March 31, 2023: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 719 $ 15 480 $ 1,107 $ 84 510 Mortgage-backed securities 257 6 144 467 42 228 Asset-backed securities 134 2 76 133 12 73 Municipal securities 48 1 28 83 8 105 Other 8 1 9 10 1 7 Total $ 1,166 $ 25 737 $ 1,800 $ 147 923 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 months or more as of December 31, 2022: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,124 $ 45 683 $ 887 $ 76 371 Mortgage-backed securities 395 20 220 319 36 131 Asset-backed securities 161 6 108 118 14 59 Municipal securities 75 4 83 57 7 57 U.S. Treasury notes 88 1 6 — — — Other 15 1 16 17 2 6 Total $ 1,858 $ 77 1,116 $ 1,398 $ 135 624 |
Medical Claims and Benefits P_2
Medical Claims and Benefits Payable (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Other Liabilities Disclosure [Abstract] | |
Schedule of Liability for Unpaid Claims and Claims Adjustment Expense | The following table provides the details of our medical claims and benefits payable as of the dates indicated: March 31, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,589 $ 2,597 Pharmacy payable 233 206 Capitation payable 95 94 Other 907 631 Total $ 3,824 $ 3,528 |
Schedule of Components of The Change in Medical Claims and Benefits Payable | The following tables present 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 years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported. Three Months Ended March 31, 2023 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,815 $ 452 $ 261 $ 3,528 Components of medical care costs related to: Current year 5,865 934 370 7,169 Prior years (250) (14) (34) (298) Total medical care costs 5,615 920 336 6,871 Payments for medical care costs related to: Current year 3,728 542 217 4,487 Prior years 1,822 369 167 2,358 Total paid 5,550 911 384 6,845 Acquired balances, net of post-acquisition adjustments — — — — Change in non-risk and other provider payables 270 — — 270 Medical claims and benefits payable, ending balance $ 3,150 $ 461 $ 213 $ 3,824 Three Months Ended March 31, 2022 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,580 $ 404 $ 379 $ 3,363 Components of medical care costs related to: Current year 5,424 840 505 6,769 Prior years (154) (25) (27) (206) Total medical care costs 5,270 815 478 6,563 Payments for medical care costs related to: Current year 3,402 465 330 4,197 Prior years 1,633 306 260 2,199 Total paid 5,035 771 590 6,396 Acquired balances, net of post-acquisition adjustments (25) — — (25) Change in non-risk and other provider payables 93 3 — 96 Medical claims and benefits payable, ending balance $ 2,883 $ 451 $ 267 $ 3,601 |
Debt (Tables)
Debt (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Debt Disclosure [Abstract] | |
Schedule of Long Term Debt | The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: March 31, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 3.875% Notes due 2030 650 650 3.875% Notes due 2032 750 750 Deferred debt issuance costs (23) (24) Total $ 2,177 $ 2,176 |
Segments (Tables)
Segments (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Segment Reporting [Abstract] | |
Schedule of Operating Segment Information | The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended March 31, 2023 2022 (In millions) Total revenue: Medicaid $ 6,578 $ 6,187 Medicare 1,056 949 Marketplace 497 616 Other 18 18 Total $ 8,149 $ 7,770 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended March 31, 2023 2022 (In millions) Margin: Medicaid $ 734 $ 710 Medicare 126 128 Marketplace 154 130 Other 2 3 Total margin 1,016 971 Add: other operating revenues (1) 246 221 Less: other operating expenses (2) (807) (820) Operating income 455 372 Other expenses, net 28 28 Income before income tax expense $ 427 $ 344 ______________________ (1) Other operating revenues include premium tax revenue, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses. |
Organization and Basis of Pre_2
Organization and Basis of Presentation (Details) member in Millions | 1 Months Ended | 3 Months Ended |
Mar. 31, 2023 state option member | Mar. 31, 2023 segment state member | |
Segment Reporting Information [Line Items] | ||
Reportable segments | segment | 4 | |
Indiana Procurement | ||
Segment Reporting Information [Line Items] | ||
Contract term | 4 years | |
Number of potential for renewals | option | 2 | |
Renewal term | 1 year | |
Health Plans | ||
Segment Reporting Information [Line Items] | ||
Number of members eligible for the health care programs, approximately | member | 5.3 | 5.3 |
Number of states with programs | state | 19 | 19 |
Health Plans | Minimum | ||
Segment Reporting Information [Line Items] | ||
Contract term | 3 years | |
Health Plans | Maximum | ||
Segment Reporting Information [Line Items] | ||
Contract term | 5 years | |
Health and Human Services | Minimum | ||
Segment Reporting Information [Line Items] | ||
Contract term | 1 year | |
Health and Human Services | Maximum | ||
Segment Reporting Information [Line Items] | ||
Contract term | 3 years |
Significant Accounting Polici_4
Significant Accounting Policies - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 | Mar. 31, 2022 | Dec. 31, 2021 |
Accounting Policies [Abstract] | ||||
Cash and cash equivalents | $ 4,554 | $ 4,006 | $ 4,804 | |
Restricted cash and cash equivalents | 43 | 62 | ||
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows | $ 4,597 | $ 4,048 | $ 4,866 | $ 4,506 |
Significant Accounting Polici_5
Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | $ 2,536 | $ 2,302 |
Government receivables | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | 1,896 | 1,702 |
Pharmacy rebate receivables | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | 275 | 291 |
Other | ||
Accounts, Notes, Loans and Financing Receivable [Line Items] | ||
Total receivables | $ 365 | $ 309 |
Significant Accounting Polici_6
Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Medicaid program: | ||
Minimum MLR, corridors, and profit sharing | $ 1,302 | $ 1,145 |
Other premium adjustments | 557 | 482 |
Medicare program: | ||
Minimum MLR and profit sharing | 85 | 84 |
Risk adjustment and Part D risk sharing | 61 | 76 |
Other premium adjustments | 27 | 27 |
Marketplace program: | ||
Risk adjustment | 278 | 230 |
Minimum MLR | 1 | 2 |
Other premium adjustments | 38 | 33 |
Total amounts due government agencies | $ 2,349 | $ 2,079 |
Significant Accounting Polici_7
Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Dec. 31, 2022 | |
Schedule of Premium Revenue by Health Plan Type [Line Items] | ||
Risk adjustment payable | $ 278 | $ 230 |
Risk adjustment receivable | 173 | 135 |
Risk adjustment, net payable | $ 105 | $ 95 |
Maturity period (less than) | 15 years | |
Structured Securities | ||
Schedule of Premium Revenue by Health Plan Type [Line Items] | ||
Average maturity period (less than) | 15 years |
Net Income Per Share (Details)
Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions | 3 Months Ended | |||
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | Dec. 31, 2021 | |
Numerator: | ||||
Net income | $ 321 | $ 258 | ||
Denominator: | ||||
Shares outstanding at the beginning of the period (in shares) | 57.4 | 57.9 | ||
Weighted-average number of shares issued: | ||||
Stock-based compensation (in shares) | 0.1 | 0.1 | ||
Denominator for basic net income per share (in shares) | 57.5 | 58 | ||
Effect of dilutive securities: | ||||
Stock-based compensation (in shares) | 0.5 | 0.7 | ||
Denominator for diluted net income per share (in shares) | 58 | 58.7 | ||
Net income per share: | ||||
Net income per share - Basic (in dollars per share) | $ 5.58 | $ 4.45 | ||
Net income per share - Diluted (in dollars per share) | $ 5.52 | $ 4.39 |
Fair Value Measurements - Finan
Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | $ 3,810 | $ 3,499 |
Total assets | 3,810 | 3,499 |
Contingent consideration liabilities | 8 | |
Total liabilities | 8 | |
Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 2,335 | 2,184 |
Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 851 | 731 |
Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 323 | 288 |
Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 151 | 149 |
U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 123 | 105 |
Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 27 | 42 |
(Level 1) | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Total assets | 0 | 0 |
Contingent consideration liabilities | 0 | |
Total liabilities | 0 | |
(Level 1) | Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 1) | Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 2) | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Total assets | 3,810 | 3,499 |
Contingent consideration liabilities | 0 | |
Total liabilities | 0 | |
(Level 2) | Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 2,335 | 2,184 |
(Level 2) | Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 851 | 731 |
(Level 2) | Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 323 | 288 |
(Level 2) | Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 151 | 149 |
(Level 2) | U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 123 | 105 |
(Level 2) | Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 27 | 42 |
(Level 3) | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Total assets | 0 | 0 |
Contingent consideration liabilities | 8 | |
Total liabilities | 8 | |
(Level 3) | Corporate debt securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Mortgage-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Asset-backed securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Municipal securities | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | U.S. Treasury notes | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | 0 | 0 |
(Level 3) | Other | ||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | ||
Debt securities, available-for-sale | $ 0 | $ 0 |
Fair Value Measurements - Narra
Fair Value Measurements - Narrative (Details) $ in Millions | 3 Months Ended |
Mar. 31, 2023 USD ($) | |
Passport Health Plan, Inc. | |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | |
Contingent consideration paid to seller included in financing and operating activities | $ 8 |
Fair Value Measurements - Long-
Fair Value Measurements - Long-Term Debt (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 2,177 | $ 2,176 |
Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 1,947 | 1,912 |
Senior Notes | 4.375% Notes due 2028 | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Debt instrument, interest rate, stated percentage | 4.375% | |
Senior Notes | 4.375% Notes due 2028 | Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 793 | 792 |
Senior Notes | 4.375% Notes due 2028 | Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 742 | 729 |
Senior Notes | 3.875% Notes due 2030 | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Debt instrument, interest rate, stated percentage | 3.875% | |
Senior Notes | 3.875% Notes due 2030 | Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 643 | 643 |
Senior Notes | 3.875% Notes due 2030 | Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 568 | 554 |
Senior Notes | 3.875% Notes due 2032 | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Debt instrument, interest rate, stated percentage | 3.875% | |
Senior Notes | 3.875% Notes due 2032 | Carrying Amount | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 741 | 741 |
Senior Notes | 3.875% Notes due 2032 | Fair Value | ||
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] | ||
Fair value of debt | $ 637 | $ 629 |
Investments - Summary of Invest
Investments - Summary of Investments (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | $ 3,974 | $ 3,709 |
Gross unrealized gains | 8 | 2 |
Gross unrealized losses | 172 | 212 |
Estimated Fair Value | 3,810 | 3,499 |
Corporate debt securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 2,428 | 2,303 |
Gross unrealized gains | 6 | 2 |
Gross unrealized losses | 99 | 121 |
Estimated Fair Value | 2,335 | 2,184 |
Mortgage-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 897 | 787 |
Gross unrealized gains | 2 | 0 |
Gross unrealized losses | 48 | 56 |
Estimated Fair Value | 851 | 731 |
Asset-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 337 | 308 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 14 | 20 |
Estimated Fair Value | 323 | 288 |
Municipal securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 160 | 160 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 9 | 11 |
Estimated Fair Value | 151 | 149 |
U.S. Treasury notes | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 123 | 106 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 0 | 1 |
Estimated Fair Value | 123 | 105 |
Other | ||
Debt Securities, Available-for-sale [Line Items] | ||
Amortized Cost | 29 | 45 |
Gross unrealized gains | 0 | 0 |
Gross unrealized losses | 2 | 3 |
Estimated Fair Value | $ 27 | $ 42 |
Investments - Contractual Matur
Investments - Contractual Maturities of Available-for-Sale Investments (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Amortized Cost | ||
Due in one year or less | $ 280 | |
Due after one year through five years | 2,340 | |
Due after five years through ten years | 455 | |
Due after ten years | 899 | |
Amortized Cost | 3,974 | $ 3,709 |
Estimated Fair Value | ||
Due in one year or less | 277 | |
Due after one year through five years | 2,245 | |
Due after five years through ten years | 443 | |
Due after ten years | 845 | |
Total | $ 3,810 |
Investments - Narrative (Detail
Investments - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Investments, Debt and Equity Securities [Abstract] | ||
Gross realized investment gains | $ 0 | $ 0 |
Gross realized investment losses | 10 | $ 0 |
Debt securities held to maturity | 242 | |
Amortized cost, due in one year or less | 123 | |
Amortized cost, due one year through five years | 111 | |
Amortized cost, due after five years | $ 8 |
Investments - Available-for-Sal
Investments - Available-for-Sale Investments (Details) $ in Millions | Mar. 31, 2023 USD ($) position | Dec. 31, 2022 USD ($) position |
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 1,166 | $ 1,858 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 25 | $ 77 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 737 | 1,116 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 1,800 | $ 1,398 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 147 | $ 135 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 923 | 624 |
Corporate debt securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 719 | $ 1,124 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 15 | $ 45 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 480 | 683 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 1,107 | $ 887 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 84 | $ 76 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 510 | 371 |
Mortgage-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 257 | $ 395 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 6 | $ 20 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 144 | 220 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 467 | $ 319 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 42 | $ 36 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 228 | 131 |
Asset-backed securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 134 | $ 161 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 2 | $ 6 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 76 | 108 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 133 | $ 118 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 12 | $ 14 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 73 | 59 |
Municipal securities | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 48 | $ 75 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 1 | $ 4 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 28 | 83 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 83 | $ 57 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 8 | $ 7 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 105 | 57 |
U.S. Treasury notes | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 88 | |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 1 | |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 6 | |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 0 | |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 0 | |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 0 | |
Other | ||
Debt Securities, Available-for-sale [Line Items] | ||
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value | $ 8 | $ 15 |
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses | $ 1 | $ 1 |
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position | 9 | 16 |
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value | $ 10 | $ 17 |
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses | $ 1 | $ 2 |
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position | 7 | 6 |
Medical Claims and Benefits P_3
Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 | Mar. 31, 2022 | Dec. 31, 2021 |
Other Liabilities Disclosure [Abstract] | ||||
Claims incurred but not paid (“IBNP”) | $ 2,589 | $ 2,597 | ||
Pharmacy payable | 233 | 206 | ||
Capitation payable | 95 | 94 | ||
Other | 907 | 631 | ||
Total | $ 3,824 | $ 3,528 | $ 3,601 | $ 3,363 |
Medical Claims and Benefits P_4
Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Other Liabilities Disclosure [Abstract] | |||
Non-risk provider payables | $ 493 | $ 228 | |
Prior period claims, favorable development | $ (298) | $ (206) |
Medical Claims and Benefits P_5
Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | $ 3,528 | $ 3,363 |
Components of medical care costs related to: | ||
Current year | 7,169 | 6,769 |
Prior years | (298) | (206) |
Total medical care costs | 6,871 | 6,563 |
Payments for medical care costs related to: | ||
Current year | 4,487 | 4,197 |
Prior years | 2,358 | 2,199 |
Total paid | 6,845 | 6,396 |
Acquired balances, net of post-acquisition adjustments | 0 | (25) |
Change in non-risk and other provider payables | 270 | 96 |
Medical claims and benefits payable, ending balance | 3,824 | 3,601 |
Medicaid | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 2,815 | 2,580 |
Components of medical care costs related to: | ||
Current year | 5,865 | 5,424 |
Prior years | (250) | (154) |
Total medical care costs | 5,615 | 5,270 |
Payments for medical care costs related to: | ||
Current year | 3,728 | 3,402 |
Prior years | 1,822 | 1,633 |
Total paid | 5,550 | 5,035 |
Acquired balances, net of post-acquisition adjustments | 0 | (25) |
Change in non-risk and other provider payables | 270 | 93 |
Medical claims and benefits payable, ending balance | 3,150 | 2,883 |
Medicare | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 452 | 404 |
Components of medical care costs related to: | ||
Current year | 934 | 840 |
Prior years | (14) | (25) |
Total medical care costs | 920 | 815 |
Payments for medical care costs related to: | ||
Current year | 542 | 465 |
Prior years | 369 | 306 |
Total paid | 911 | 771 |
Acquired balances, net of post-acquisition adjustments | 0 | 0 |
Change in non-risk and other provider payables | 0 | 3 |
Medical claims and benefits payable, ending balance | 461 | 451 |
Marketplace | ||
Insurance Claims | ||
Medical claims and benefits payable, beginning balance | 261 | 379 |
Components of medical care costs related to: | ||
Current year | 370 | 505 |
Prior years | (34) | (27) |
Total medical care costs | 336 | 478 |
Payments for medical care costs related to: | ||
Current year | 217 | 330 |
Prior years | 167 | 260 |
Total paid | 384 | 590 |
Acquired balances, net of post-acquisition adjustments | 0 | 0 |
Change in non-risk and other provider payables | 0 | 0 |
Medical claims and benefits payable, ending balance | $ 213 | $ 267 |
Debt - Schedule of Long-Term De
Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions | Mar. 31, 2023 | Dec. 31, 2022 |
Debt Instrument [Line Items] | ||
Deferred debt issuance costs | $ (23) | $ (24) |
Total | $ 2,177 | 2,176 |
Senior Notes | 4.375% Notes due 2028 | ||
Debt Instrument [Line Items] | ||
Percentage of contractual interest rate on notes | 4.375% | |
Non-current portion of long-term debt | $ 800 | 800 |
Senior Notes | 3.875% Notes due 2030 | ||
Debt Instrument [Line Items] | ||
Percentage of contractual interest rate on notes | 3.875% | |
Non-current portion of long-term debt | $ 650 | 650 |
Senior Notes | 3.875% Notes due 2032 | ||
Debt Instrument [Line Items] | ||
Percentage of contractual interest rate on notes | 3.875% | |
Non-current portion of long-term debt | $ 750 | $ 750 |
Debt - Narrative (Details)
Debt - Narrative (Details) | 3 Months Ended |
Mar. 31, 2023 USD ($) | |
Line of Credit | |
Debt Instrument [Line Items] | |
Debt term | 5 years |
Line of Credit | Credit Facility | |
Debt Instrument [Line Items] | |
Maximum borrowing capacity | $ 1,000,000,000 |
Amount outstanding under letter of credit | $ 0 |
Senior Notes | 4.375% Notes due 2028 | |
Debt Instrument [Line Items] | |
Percentage of contractual interest rate on notes | 4.375% |
Face amount | $ 800,000,000 |
Senior Notes | 3.875% Notes due 2030 | |
Debt Instrument [Line Items] | |
Percentage of contractual interest rate on notes | 3.875% |
Face amount | $ 650,000,000 |
Senior Notes | 3.875% Notes due 2032 | |
Debt Instrument [Line Items] | |
Percentage of contractual interest rate on notes | 3.875% |
Face amount | $ 750,000,000 |
Segments - Narrative (Details)
Segments - Narrative (Details) | 3 Months Ended |
Mar. 31, 2023 segment | |
Segment Reporting [Abstract] | |
Reportable segments | 4 |
Segments - Operating Segment In
Segments - Operating Segment Information (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Segment Reporting Information [Line Items] | ||
Revenues | $ 8,149 | $ 7,770 |
Medicaid | ||
Segment Reporting Information [Line Items] | ||
Revenues | 6,578 | 6,187 |
Medicare | ||
Segment Reporting Information [Line Items] | ||
Revenues | 1,056 | 949 |
Marketplace | ||
Segment Reporting Information [Line Items] | ||
Revenues | 497 | 616 |
Other | ||
Segment Reporting Information [Line Items] | ||
Revenues | $ 18 | $ 18 |
Segments - Reconciliation of Gr
Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | $ 8,149 | $ 7,770 |
Less: other operating expenses | (7,694) | (7,398) |
Operating income | 455 | 372 |
Other expenses, net | 28 | 28 |
Income before income tax expense | 427 | 344 |
Medicaid | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 6,578 | 6,187 |
Medicare | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 1,056 | 949 |
Marketplace | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 497 | 616 |
Other | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 18 | 18 |
Operating segments | ||
Segment Reporting Information [Line Items] | ||
Total margin | 1,016 | 971 |
Operating segments | Medicaid | ||
Segment Reporting Information [Line Items] | ||
Total margin | 734 | 710 |
Operating segments | Medicare | ||
Segment Reporting Information [Line Items] | ||
Total margin | 126 | 128 |
Operating segments | Marketplace | ||
Segment Reporting Information [Line Items] | ||
Total margin | 154 | 130 |
Operating segments | Other | ||
Segment Reporting Information [Line Items] | ||
Total margin | 2 | 3 |
Other operating | ||
Segment Reporting Information [Line Items] | ||
Add: other operating revenues | 246 | 221 |
Less: other operating expenses | $ (807) | $ (820) |