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J. Mario Molina, MD
CEO and Chairman

April 27, 2017
The Honorable Paul Ryan The Honorable Mitch McConnell
Speaker of the House Majority Leader
U.S. House of Representatives U.S. Senate
Washington, DC 20515 Washington, DC 20510
The Honorable Nancy Pelosi The Honorable Charles E. Schumer
Minority Leader Minority Leader
U.S. House of Representatives U.S. Senate
Washington, DC 20515 Washington, DC 20510

Dear Mr. Speaker, Majority Leader McConnell, Minority Leader Pelosi, and Minority Leader Schumer:

In 1980, Molina Healthcare, Inc. (?Molina?) was founded to provide quality health services to ?nancially
vulnerable families and individuals. We entered the Health Insurance Marketplaces in 2014 with the goal
of seamlessly covering our members as changes in eligibility moved them between coverage programs.
We remain committed to this goal and to providing access to quality, affordable coverage if Congress and
the Administration take important steps to stabilize the Marketplace for 2017 and beyond.

Currently we serve 1,035,000 members through the Health Insurance Marketplaces in 2017, making
Molina one of the largest participants in this program. About 9% of all persons enrolled in the
Marketplace are members of Molina Healthcare.

Cost-sharing subsidies (CSR) have been essential for making coverage affordable for many members.
Sixty-?ve percent of Molina Marketplace members are enrolled in plans with cost sharing subsidies.
Removing them will make coverage unaffordable. We entered into these Marketplace contracts with the
expectation that the cost sharing reductions would continue to be fully funded. If the CSR funding
continues, we intend to maintain our participation in the Marketplace for 2018.

The CSR has been calculated into our premium rates. The CSRs are paid directly to the health plans.
When eligible low-income members obtain services, based on their income-level, they pay reduced co-
payments and deductibles. The CSR is used by the health plan to pay the provider and make up the
difference between the actual co-pay or deductible and what the member actually pays. This money goes
directly to providers from the health plan. Any of the CSR money that goes unused is returned to the
Federal government. Thus, this is not a bail-out or windfall to the insurance company.

Molina Healthcare, Inc. 0 200 Oceangate. Suite 100, Long Beach, CA 90802
562-435-3666 0 Fax: 562-951-1505

If the CSR is not funded, we will have no choice but to send a notice of default informing the government
that we are dropping our contracts for their failure to pay premiums and seek to withdraw from the
Marketplace immediately. That would result in about 650,000 to 700,000 people losing insurance
coverage in 2017, and we would not participate in Marketplace in 2018 resulting in over 1 million
Americans losing health insurance coverage.

We urge Congress and the Administration to act quickly to ensure CSRs are funded for the remainder of
2017 and also for 2018. We look forward to continuing to work with you to provide comprehensive,
affordable Marketplace coverage to consumers.

Sincerely,



J. Mario Molina, MD.
Chief Executive Of?cer