Molina executives explain ACA exchange plan claim flow

Executives at Molina Healthcare say they are still happy with the business their company is getting from the Affordable Care Act public health insurance exchange system.

The Long Beach, California-based Medicaid issuer has focused on appealing to exchange users who earn less than 250 percent of the federal poverty level, who may be churning between the exchange system and Medicaid, and getting heavy premium subsidies and cost-sharing reduction subsidies when they do use exchange plans.

The overall level of health of those people is about what Molina had expected, and better than the level of health of the other government plan enrollees the company covers, according to Joseph White, the company’s chief accounting officer.

Compared with what the company was seeing before, “we’re not seeing a huge number of chronically ill members,” White said Wednesday during a conference call with securities analysts.

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Molina held the call to go over earnings for the second quarter.

The company is reporting $33 million in net income for the quarter on $4.4 billion in revenue, compared with $39 million in net income on $3.5 billion in revenue for the second quarter of 2015.

The company ended the quarter providing or administering medical coverage for 4.2 million people, up from 3.4 million people a year earlier.

Enrollment in Medicaid plans affected by the ACA Medicaid expansion program increased to 654,000, from 475,000.

Enrollment in ACA exchange plans increased to 597,000, from 261,000.

The company says it expects claim costs to rise as enrollees meet their deductibles and the special enrollment period brings in sicker enrollees