Molina Healthcare Inc (MOH) 2025 Q2 法說會逐字稿

Good day and welcome to the Molina Healthcare second quarter 2025 earnings conference call. All participants will be in listen-only mode. (Operator Instructions) Please note this event has been recorded.

大家好，歡迎參加 Molina Healthcare 2025 年第二季財報電話會議。所有參與者將處於只聽模式。（操作員指示）請注意，此事件已被記錄。

I would now like to turn the conference over to Jeff Geyer, Vice President of Investor Relations. Please go ahead.

現在，我想將會議交給投資者關係副總裁 Jeff Geyer。請繼續。

Good morning, and welcome to Molina Healthcare's second quarter 2025 earnings call. Joining me today are Molina's President and CEO, Joe Zubretsky; and our CFO, Mark Keim. A press release announcing our second quarter 2025 earnings was distributed after the market closed yesterday and is available on our Investor Relations website.

早安，歡迎參加 Molina Healthcare 2025 年第二季財報電話會議。今天與我一起出席的還有 Molina 總裁兼執行長 Joe Zubretsky 和我們的財務長 Mark Keim。我們在昨日股市收盤後發布了一份新聞稿，宣布了 2025 年第二季的收益，可在我們投資者關係網站上查閱。

Shortly after the conclusion of this call, a replay will be available for 30 days. The numbers to access the replay are in the earnings release. For those of you who listen to the rebroadcast of this presentation, we remind you that all of the remarks are made as of today, Thursday, July 24, 2025 and have not been updated subsequent to the initial earnings call.

本次通話結束後不久，重播將保留 30 天。觀看重播的數字可在收益報告中找到。對於那些收聽本次演講重播的人來說，我們提醒您，所有的評論都是截至今天，即 2025 年 7 月 24 日星期四做出的，並且在首次收益電話會議之後尚未更新。

On this call, we will refer to certain non-GAAP measures. A reconciliation of these measures with the most directly comparable GAAP measures can be found in the second quarter 2025 earnings release. During the call, we will be making certain forward-looking statements, including, but not limited to, statements regarding our 2025 guidance and 2025 guidance elements, the medical cost trend and our projected MCRs,

在本次電話會議中，我們將參考某些非公認會計準則指標。在 2025 年第二季財報中可以找到這些指標與最直接可比較的 GAAP 指標的對帳。在電話會議期間，我們將做出某些前瞻性陳述，包括但不限於有關我們的 2025 年指導和 2025 年指導要素、醫療成本趨勢和我們預期的 MCR 的陳述，

Medicaid rate adjustments and updates our 2026 marketplace pricing and rate filings, our RFP awards and our M&A activity, revenue growth related to RFPs and M&A activity, the recently enacted big, beautiful bill and expected Medicaid, Medicare and Marketplace program changes and the estimated amount of our embedded earnings power.

醫療補助費率調整併更新了我們的 2026 年市場定價和費率備案、我們的 RFP 獎項和我們的併購活動、與 RFP 和併購活動相關的收入增長、最近頒布的大型、美麗的法案和預期的醫療補助、醫療保險和市場計劃變化以及我們內含盈利能力的估計數額。

Listeners are cautioned that all of our forward-looking statements are subject to certain risks and uncertainties that could cause our actual results to differ materially from our current expectations. We advise listeners to review the risk factors discussed in our Form 10-K annual report filed with the SEC as well as our risk factors listed in our Form 10-Q and Form 8-K filings with the SEC. After the completion of our prepared remarks, we will open the call to take your questions.

請聽眾注意，我們所有的前瞻性陳述都受到某種風險和不確定性的影響，這可能導致我們的實際結果與我們目前的預期有重大差異。我們建議聽眾查看我們向美國證券交易委員會提交的 10-K 表年度報告中討論的風險因素以及我們向美國證券交易委員會提交的 10-Q 表和 8-K 表中列出的風險因素。在我們完成準備好的演講後，我們將開始回答您的問題。

I will now turn the call over to our Chief Executive Officer, Joe Zubretsky. Joe?

現在我將電話轉給我們的執行長喬·祖布雷茨基 (Joe Zubretsky)。喬？

Thank you, Jeff, and good morning. Today, I will discuss several topics, our reported financial results for the second quarter, an update on our full year 2025 guidance. Our growth initiatives and strategy for sustaining profitable growth and some commentary on the potential impacts of the recently passed budget bill. Let me start with our second quarter performance, which greatly informs our discussion on 2025 guidance.

謝謝你，傑夫，早安。今天，我將討論幾個主題，我們報告的第二季財務業績，以及我們 2025 年全年指引的最新情況。我們的成長計劃和維持獲利成長的策略以及對最近通過的預算法案的潛在影響的一些評論。首先，我想談談我們第二季的業績，這對我們討論 2025 年的指導意義重大。

Last night, we reported adjusted earnings per share of $5.48 on $10.9 billion of premium revenue. Our 90.4% consolidated MCR reflects a very challenging medical cost trend environment, but moderated by our consistently effective medical cost management. We produced a 3.3% adjusted pretax margin. Year-to-date, our consolidated MCR is 89.8%, and our adjusted pretax margin is 3.6%. In Medicaid, the business produced an MCR of 91.3%, which is above our long-term target range.

昨晚，我們報告稱，調整後的每股收益為 5.48 美元，保費收入為 109 億美元。我們 90.4% 的合併 MCR 反映了極具挑戰性的醫療成本趨勢環境，但受到我們一貫有效的醫療成本管理的緩和。我們實現了 3.3% 的調整後稅前利潤率。年初至今，我們的合併 MCR 為 89.8%，調整後的稅前利潤率為 3.6%。在醫療補助方面，該業務的 MCR 為 91.3%，高於我們的長期目標範圍。

We continue to experience medical cost pressure in behavioral pharmacy and inpatient and outpatient care. Let me expand on what we are seeing in our Medicaid business. Behavioral health costs have increased nationally reflecting both supply side and demand side drivers and imposed limitations on utilization management in certain states. High-cost drugs remain a source of pressure driven by higher script volumes and the introduction of a variety of expensive therapies beyond GLP-1s for conditions such as cancer and HIV.

我們在行為藥房以及住院和門診護理方面繼續面臨醫療成本壓力。讓我詳細說明一下我們在醫療補助業務中看到的情況。全國範圍內行為健康成本有所增加，反映了供給側和需求側的驅動因素，並對某些州的利用管理施加了限制。高成本藥物仍然是一個壓力來源，原因是處方量增加，以及除 GLP-1 之外還引入了多種用於治療癌症和愛滋病等疾病的昂貴療法。

Higher inpatient utilization in the quarter was driven by a higher volume of admissions for complex health episodes, many of which originated from increased ER visits. And the increase in outpatient utilization in the quarter was driven by primary care visits and preventive screenings, many of which led to subsequent treatment in specialist settings. This is the fourth consecutive quarter we have observed some combination of these trends.

本季住院病患利用率的提高是由於複雜健康事件入院人數的增加，其中許多源自於急診室就診次數的增加。本季門診利用率的增長是由初級保健就診和預防性篩檢推動的，其中許多導致了隨後在專科環境中接受治療。這是我們連續第四個季度觀察到這些趨勢的組合。

The magnitude and persistence of these medical cost increases are unprecedented. To briefly recap how these trends have emerged over time. Starting in the third quarter of 2024, while an increasing trend emerged from the end of the redetermination process, rates and Molina's risk corridor positions at that increasing trend.

醫療費用上漲的幅度和持續時間是前所未有的。簡單回顧一下這些趨勢是如何隨著時間而出現的。從 2024 年第三季開始，雖然重新確定過程結束後出現了上升趨勢，但利率和莫利納風險走廊仍處於上升趨勢中。

By the fourth quarter of 2024, the increasing medical cost trend moved Beyond the 2024 midyear rate updates and corridors have largely become depleted. Moving into the first quarter of 2025, the January 1 rate cycle captured much of the continued trend pressure.

到 2024 年第四季度，醫療成本上漲趨勢已超出 2024 年中期費率更新的範圍，且利率區間已基本耗盡。進入 2025 年第一季度，1 月 1 日的利率週期捕捉了大部分持續的趨勢壓力。

And now in the second quarter of 2025, we experienced yet another increase in trend would move beyond the rate updates received in the first quarter and risk corridor protection at this point is very limited and isolated. We are confident our cost control protocols and procedures continue to be effective albeit applied to much higher intake volumes.

現在到了 2025 年第二季度，我們又經歷了一次趨勢增長，將超越第一季收到的利率更新，此時的風險走廊保護非常有限且孤立。我們相信，儘管我們的成本控制協議和程序適用於更高的攝取量，但它仍然有效。

Cross data indicates a higher prevalence of allowable and appropriate diagnosis and medical procedures. In Medicare, we reported a second quarter MCR of 90% which is above our long-term target range as utilization was higher in the more acute populations, particularly for long-term services and supports and high-cost drugs.

交叉數據顯示允許和適當的診斷和醫療程序的普及率較高。在醫療保險方面，我們報告第二季的 MCR 為 90%，高於我們的長期目標範圍，因為在更急性的人群中利用率更高，特別是對於長期服務和支持以及高成本藥物。

In Marketplace, the second quarter MCR of 85.4% was much higher than expected, including the new store MCR related to Connecticut. We continue to experience much higher utilization relative to risk adjustment revenue, the rata which has now been validated by external sources. Our adjusted G&A ratio at 6.1% reflects lower incentive compensation as a result of our revised view of performance as well as continue productivity enhancement.

在 Marketplace 中，第二季的 MCR 為 85.4%，遠高於預期，其中包括與康乃狄克州相關的新店 MCR。我們持續經歷相對於風險調整收入更高的使用率，這一比例現已得到外部來源的驗證。我們的調整後 G&A 比率為 6.1%，反映了由於我們對績效的修改以及生產力的持續提高而導致的激勵薪酬降低。

Turning now toward 2025 guidance. Full year 2025 premium revenue guidance remains unchanged at approximately $42 billion. Our full year 2025 adjusted earnings per share guidance is now expected to be no less than $19 per share, a floor, if you will, which is $5.50 below our initial guidance of $24.50 and $3 lower than the midpoint of what was recently communicated on July 7.

現在轉向 2025 年指導。2025年全年保費收入預期維持不變，約420億美元。我們現在預計 2025 年全年調整後每股盈餘指引將不低於每股 19 美元，這是一個下限，比我們最初指引的 24.50 美元低 5.50 美元，比 7 月 7 日最近傳達的中點低 3 美元。

Providing some color. This further revision results from new information gained in our June close process and implications for trend assumptions for the second half of the year, particularly related to marketplace. We use this most recent experience data to forecast the balance of the year, which resulted in a more conservative view and a view within a wider range of probable outcomes than is normal for this point in the year.

提供一些顏色。進一步修訂源自於我們在 6 月結算過程中獲得的新資訊以及對下半年趨勢假設的影響，特別是與市場相關的趨勢假設。我們利用最新的經驗數據來預測今年的餘額，結果得出了比今年這個時候的正常情況更保守的觀點和更廣泛的可能結果範圍的觀點。

This revised guidance of a $19 floor produces a consolidated MCR and pretax margin of 90.2% and 3.1%, respectively. Our full year guidance now includes 140 basis points of consolidated MCR pressure compared to our initial guidance at $24.50, which is disproportionately attributed to marketplace. Marketplace is 10% of our revenue and accounts for nearly half of this 140 basis point MCR revision.

修訂後的 19 美元底價指導價分別產生了 90.2% 和 3.1% 的合併 MCR 和稅前利潤率。我們的全年指導現在包括 140 個基點的合併 MCR 壓力，而我們最初的指導為 24.50 美元，這主要歸因於市場。市場占我們收入的 10%，佔 140 個基點 MCR 修訂的近一半。

We consider the $19 guidance to be a floor as we believe the cost trend could moderate from this conservative indication and produce earnings upside. A reminder that 35 basis points of MCR in the second half equates to $1 of upside earnings per share potential.

我們認為 19 美元的指導價是一個底線，因為我們相信成本趨勢可能會從這個保守的指標緩和下來，並產生獲利上升空間。提醒一下，下半年的 35 個基點的 MCR 相當於每股 1 美元的上行收益潛力。

Now some color around the segments. In Medicaid, our guidance assumes a full year MCR of 90.9%, which produces a pretax margin of 3.6%, while this Medicaid MCR result is above the high end of our long-term target range, we do evaluate it in the context of this unprecedented and challenging trend environment. We received on-cycle rate adjustments and new off-cycle rate updates in a few states that will benefit the second half of 2025. Then with approximately 55% of our Medicaid premium renewing on January 1, our rate cycle is well timed for early 2026.

現在為片段周圍添加一些顏色。在醫療補助方面，我們的指導假設全年 MCR 為 90.9%，產生 3.6% 的稅前利潤率，雖然醫療補助 MCR 結果高於我們長期目標範圍的高端，但我們確實是在這種前所未有且充滿挑戰的趨勢環境中對其進行評估的。我們在一些州收到了周期內利率調整和新的非週期利率更新，這將使 2025 年下半年受益。然後，由於我們的約 55% 的醫療補助保費將於 1 月 1 日續保，我們的費率週期恰逢 2026 年初。

There is little question that most state programs are significantly underfunded as a result of medical cost inflection. We have very strong rate advocacy efforts working with our state partners to restore rates to appropriate levels. States are listening and have been responsive. With that in mind, our own analysis validated by fat-based external reports, has us operating with Medicaid MCR 2 to 300 basis points lower than the broader market. When rates and trends reach equilibrium for the broader market, we should be back to operating within our long-term target range.

毫無疑問，由於醫療成本變動，大多數州的醫療計畫都嚴重資金不足。我們與州合作夥伴一起大力倡導利率，以將利率恢復到適當水平。各州正在傾聽並做出了回應。考慮到這一點，我們自己的分析透過基於脂肪的外部報告得到驗證，我們的醫療補助 MCR 比大盤低 2 到 300 個基點。當利率和趨勢達到大盤的平衡時，我們應該回到長期目標範圍內運作。

In Medicare, our full year guidance includes an MCR of 90% and a low single-digit pretax margin. We continue to effectively manage the elevated utilization through our cost control protocols. We consider this higher cost trend in our bids for 2026 and remain strategically focused on our dual eligible population.

在醫療保險方面，我們的全年指引包括 90% 的 MCR 和低個位數的稅前利潤率。我們繼續透過成本控制協議有效地管理提高的利用率。我們在 2026 年的競標中考慮到了這種成本上升趨勢，並繼續將策略重點放在雙重合格人口上。

In Marketplace, at this time in the cycle, the focus is not only on the second half of 2025, but also on the positions taken in rate filings for 2026. With respect to full year 2025 we expect to produce an MCR of 85% and a pretax margin in the low single digits. This result includes the pressure from the prior year items we recognized in the first half and the new store impact of ConnectiCare.

在市場中，在這個週期中，關注的重點不僅在於 2025 年下半年，還在於 2026 年利率申報中所採取的立場。對於 2025 年全年，我們預期 MCR 為 85%，稅前利潤率為個位數。這一結果包括了我們在上半年確認的上年專案的壓力以及 ConnectiCare 新店的影響。

We conservatively forecasted medical cost trend and our risk adjustment revenue, the rata which has now been validated by external sources. As it is clear that the market-wide risk pool is higher acuity. Medical cost trend relative to risk adjustment continues to produce a higher-than-expected MCR. And we have considered this higher cost baseline and trend in our rate filings for 2026. More on that later, as rates for 2026 will also be affected by the expiration of the enhanced subsidies and program integrity policies.

我們保守地預測了醫療成本趨勢和我們的風險調整收入，該比例現已得到外部來源的驗證。顯然，整個市場的風險池具有更高的敏銳度。相對於風險調整的醫療成本趨勢持續產生高於預期的 MCR。我們在 2026 年的費率申報中考慮了這個更高的成本基準和趨勢。稍後我們將對此進行詳細介紹，因為 2026 年的費率也將受到增強補貼和計畫完整性政策到期的影響。

Our small silver and stable approach to this line of business, where we target mid-single-digit margins even at the expense of growth was deliberate and well considered. This line of business has significant inherent volatility and a constantly shift in risk pool. We have limited this segment to just 10% of our portfolio and we always approach it cautiously.

我們對這條業務線採取了小規模、穩定的做法，即即使以犧牲成長為代價，我們也瞄準中等個位數的利潤率，這是經過深思熟慮的。該業務線具有很大的內在波動性，且風險池不斷變化。我們將這一部分限制在我們投資組合的 10% 以內，並且我們始終謹慎對待它。

In summary, with respect to our full year guidance, we provide it with full confidence, quantification and detail in this season of great uncertainty. Turning now to our growth initiatives. We remain on track to achieving our premium revenue target of $46 billion in 2026, and with a modest estimate of future growth initiatives, at least $52 billion for 2027.

總而言之，對於我們的全年指引，在這個充滿不確定性的季節，我們以充分的信心、量化和細節來提供指引。現在來談談我們的成長計畫。我們仍有望實現 2026 年 460 億美元的保費收入目標，並且根據對未來成長計畫的保守估計，到 2027 年至少可實現 520 億美元的保費收入。

Our outlook considers growth in our current footprint and recent Medicaid and Medicare duals RFP wins. These wins should more than offset the marketplace headwind due to the expiration of enhanced subsidies. This outlook is before considering any impacts of membership declines due to the budget bill, which we continue to evaluate in size and believe the ultimate impact of which is likely to manifest beyond 2028.

我們的展望考慮了我們目前的業務範圍的增長以及最近醫療補助和醫療保險雙重 RFP 的勝利。這些收益應該足以抵消因增加補貼到期而帶來的市場阻力。這項展望尚未考慮預算法案導致的會員人數下降的影響，我們將繼續評估預算法案的規模，並相信其最終影響可能會在 2028 年以後顯現。

With respect to M&A activity, our acquisition pipeline still contains many actionable opportunities, and we remain opportunistic in deploying capital to accretive acquisitions. This current challenging operating environment has been a catalyst for many smaller and less diverse health plans to consider their strategic options, creating more opportunities.

就併購活動而言，我們的收購管道中仍包含許多可行的機會，我們仍會抓住機會將資本部署到增值收購中。當前充滿挑戰的營運環境促使許多規模較小、多樣性較低的醫療計劃考慮其策略選擇，從而創造了更多機會。

Our embedded earnings, which accounts for the estimated accretion related to new contract wins and recent acquisitions remains at $8.65 per share. For all of these reasons, we remain confident in our long-term growth targets. Turning now to the political and legislative landscape and the related long-term outlook for our businesses.

我們的內含收益（包括與新合約簽訂和近期收購相關的預期增值）仍為每股 8.65 美元。由於所有這些原因，我們對我們的長期成長目標仍然充滿信心。現在來談談政治和立法情況以及與我們業務相關的長期前景。

In Medicaid, we believe changes in the Medicaid program related to the recently passed budget bill will be modest and gradual. We evaluate its impact in two broad categories direct and indirect. By direct impact, we mean any impact specific to our actual membership and the potential for a related risk pool acuity shift.

在醫療補助方面，我們相信與最近通過的預算法案相關的醫療補助計劃的變化將是溫和而漸進的。我們從直接和間接兩大類來評估其影響。直接影響是指對我們的實際成員資格產生的任何特定影響以及相關風險池敏銳度轉變的可能性。

Note that for the expansion population, work requirements commenced in 2027 or later by approval. Biannual reverifications also commenced in 2027 or later by approval as well. We continue to estimate that the ultimate impact will be in the range of 15% to 20% on the 1.3 million members in our expansion population.

請注意，對於擴展人口，工作要求於 2027 年或之後開始，並經批准。每兩年一次的重新驗證也將於 2027 年或之後經批准開始。我們繼續估計，最終的影響將對我們擴展人口中的 130 萬會員產生 15% 至 20% 的影響。

As many of these members will automatically qualify as a result of exclusions and two by three already work in some capacity. By indirect impacts to the program, we are referring to funding reductions not expressly linked to certain populations. For instance, it is more difficult to predict how states will react to the reductions in federal funding resulting from limitations on directed payments and provider taxes.

由於排除，這些成員中的許多人將自動獲得資格，並且三分之二的人已經以某種身份工作。對於該計劃的間接影響，我們指的是與某些人群沒有明確關聯的資金減少。例如，更難預測各州將如何應對因定向支付和提供者稅的限製而導致的聯邦資金減少。

States could limit eligibility, reduce benefits or keep their programs intact by funding it with additional state revenues. We anticipate that whatever a state elects to do will follow prevailing state-specific political tendencies. We believe these changes will be implemented over the course of the 2-year period of 2027 and in 2028 and possibly into 2029 and therefore, allow the market time to react appropriately, so any impact would be gradual and not abrupt.

各州可以限制資格、減少福利或透過增加州收入來資助其計劃，以保持其計劃的完整性。我們預計，一個國家所做的任何選擇都將遵循該國現行的政治傾向。我們相信這些變化將在 2027 年、2028 年甚至 2029 年的兩年內實施，因此，市場有時間做出適當的反應，因此任何影響都將是漸進的，而不是突然的。

Finally, in marketplace, we continue to expect the enhanced subsidies will not be extended beyond this year. External sources estimate a significant industry impact to 2026 enrollment. In addition to taking a conservative view of the current medical cost baseline and forward trend, we are attempting to conservatively capture the potential related acuity shift in the risk pool in our 2026 rate filings.

最後，在市場上，我們繼續預期增加的補貼將不會延續到今年以後。外部消息來源估計該行業將對 2026 年的入學人數產生重大影響。除了對當前醫療成本基線和未來趨勢持保守態度外，我們還試圖在 2026 年費率申報中保守地捕捉風險池中潛在的相關敏銳度變化。

Most of our states have confirmed that they will allow market participants a second pass rate filing, which will give us a last look based on the most current information available, thus mitigating any mispricing risk. Regardless, our strategy of keeping this business small, stable and oriented towards silver tiered products has served us well.

大多數州已確認將允許市場參與者進行第二次通過率申報，這將使我們根據現有的最新資訊進行最後一次審查，從而減輕任何錯誤定價風險。無論如何，我們保持業務規模小、穩定、面向銀級產品的策略對我們非常有利。

In summary, we are disappointed with our second quarter results and guidance revision, even in the backdrop of this difficult environment of accelerating medical cost. In Medicaid, where health plan participants are essentially rate takers, we believe this dislocation between rates and trend is temporary and will normalize over time, just as it has in the past years of the program.

總而言之，即使在醫療成本加速上漲的艱困環境下，我們對第二季的業績和指引修訂感到失望。在醫療補助計劃中，健康計劃參與者基本上是費率接受者，我們認為費率和趨勢之間的錯位是暫時的，並且會隨著時間的推移而正常化，就像該計劃過去幾年的情況一樣。

And in Marketplace, where there has been significantly increased utilization relative to risk adjustment, our rate filing process, we'll address this incongruity and restore the product to target margins. I do step back and take stock, in doing so, I am encouraged by a number of observations that deserve emphasis.

在市場中，相對於風險調整（我們的利率申報流程）的利用率顯著提高，我們將解決這種不協調現象，並將產品恢復到目標利潤率。我確實退後一步並進行評估，當我這樣做時，我受到許多值得強調的觀察結果的鼓舞。

Even in this broadly challenging environment, we have the confidence and clarity to provide a specific earnings per share guidance floor with upside potential. We continue to grow premium this year at 9% and 19% over the past few years.

即使在這種充滿挑戰的環境中，我們仍有信心和清晰度來提供具有上行潛力的具體每股收益指導底線。今年我們的保費持續成長 9%，過去幾年則成長 19%。

Our consolidated MCR outlook is 90.2% and in an extended period of accelerating trend. When combined with our G&A efficiencies harvested over the past number of years, we are still projecting a full year 3.1% pretax margin, which is just 90 basis points off the lower end of our long-term range.

我們的綜合 MCR 展望為 90.2%，並且處於長期加速趨勢。結合過去幾年我們獲得的一般及行政管理效率，我們仍預期全年稅前利潤率為 3.1%，僅比我們長期範圍的下限低 90 個基點。

And finally, with margins normalizing as we are heading towards $46 billion and $52 billion of premium revenue, in 2026 and 2027. We are very well positioned to reestablish our profitable growth trajectory. At Molina, we power through short-term industry-wide challenges and strive to deliver superior sector performance.

最後，隨著利潤率的正常化，我們的保費收入將在 2026 年和 2027 年分別達到 460 億美元和 520 億美元。我們已做好準備，重新建立獲利成長軌跡。在 Molina，我們努力克服短期產業挑戰，並努力實現卓越的產業績效。

We have built a durable government-sponsored health care franchise. This franchise has been signed to deliver results with the same consistency and commitment to operating excellence that has been our hallmark. With that, I will turn the call over to Mark for some additional color on the financials. Mark?

我們已經建立了持久的政府資助的醫療保健特許經營權。簽署該特許經營協議的目的是為了以同樣的一致性和對卓越營運的承諾來取得成果，這也是我們的標誌。說完這些，我將把電話轉給馬克，讓他對財務狀況做進一步的說明。標記？

Thanks, Joe, and good morning, everyone. Today, I'll discuss additional details of our second quarter performance, the balance sheet and our 2025 guidance. Beginning with our second quarter results. For the quarter, we reported approximately $11 billion in total revenue and $10.9 billion of premium revenue with adjusted EPS of $5.48.

謝謝，喬，大家早安。今天，我將討論我們第二季業績、資產負債表和 2025 年指引的更多細節。從我們的第二季業績開始。本季度，我們的總營收約為 110 億美元，保費收入為 109 億美元，調整後每股收益為 5.48 美元。

Our second quarter consolidated MCR was $90.4 million reflecting a very challenging medical cost trend environment for each of our segments, but moderated by our consistently effective medical cost management. In Medicaid, our second quarter MCR was 91.3%, higher than our expectations. We continue to experience medical cost pressure in behavioral, pharmacy in the inpatient and outpatient care settings that Joe summarized.

我們第二季的合併 MCR 為 9,040 萬美元，這反映了我們每個部門都面臨著非常嚴峻的醫療成本趨勢環境，但我們一貫有效的醫療成本管理緩和了這一情況。在醫療補助方面，我們第二季的 MCR 為 91.3%，高於我們的預期。正如喬總結的那樣，我們在住院和門診護理環境中的行為、藥房方面繼續面臨醫療成本壓力。

The combination of these trends exceeded rate updates received in the first half of the year. In Medicare, our second quarter MCR was 90%, also higher than our expectations. We experienced higher utilization among our high-acuity duals populations, particularly for LTSS and high-cost pharmacy drugs. We remain confident in our cost controls.

這些趨勢的綜合影響超過了今年上半年收到的利率更新。在醫療保險方面，我們第二季的 MCR 為 90%，也高於我們的預期。我們的高敏銳度雙重人群的利用率更高，特別是對於 LTSS 和高成本藥房藥物。我們對我們的成本控制仍然充滿信心。

In marketplace our second quarter reported MCR was $85.4 million, similar to first quarter, the MCR includes approximately 150 basis points of higher new store MCR in ConnectiCare, and 150 basis points for member reconciliation from previous years. Excluding these items, the normalized MCR of approximately $82.4 million was higher than we expected.

在市場上，我們第二季報告的 MCR 為 8,540 萬美元，與第一季度相似，MCR 包括 ConnectiCare 中約 150 個基點的更高新店 MCR，以及前幾年的會員對帳的 150 個基點。除去這些項目，標準化的 MCR 約為 8240 萬美元，高於我們的預期。

Utilization among our renewing membership and new membership was elevated compared to previous guidance. While risk adjustment might normally offset higher observed trend, our market indicators clearly suggest that the overall market risk pool is also significantly elevated.

與先前的指導相比，我們的續約會員和新會員的利用率有所提高。雖然風險調整通常會抵消觀察到的更高趨勢，但我們的市場指標清楚地表明，整體市場風險池也顯著增加。

We reducing the value of the natural hedging effect of risk adjustment. The initial wake lies just received in late June clearly confirmed that national marketplace risk pools are trending higher. Our adjusted G&A ratio for the quarter was $6.1 significantly below normal levels, reflecting reduced incentive compensation tied to lower expected performance and our normal operating discipline.

我們降低了風險調整的自然對沖效應的價值。6 月底剛收到的初步警示消息清楚證實，全國市場風險池呈現上升趨勢。本季我們調整後的 G&A 比率為 6.1 美元，遠低於正常水平，反映出與預期業績下降和正常營運紀律相關的激勵薪酬減少。

Turning to the balance sheet. Our capital foundation remains strong. In the quarter, we harvested approximately $260 million of subsidiary dividends and our parent company cash balance was approximately $100 million at the end of the quarter. Our operating cash flow for the first six months of 2025 was an outflow of $100 million due to the timing of government receivables and risk corridor settlement activity that offset the normal positive items.

轉向資產負債表。我們的資本基礎依然強勁。本季度，我們收穫了約 2.6 億美元的子公司股息，季度末母公司現金餘額約為 1 億美元。由於政府應收帳款的時間安排和風險走廊結算活動抵消了正常的正值項目，我們 2025 年前六個月的營運現金流流出 1 億美元。

Debt at the end of the quarter was reduced by approximately $200 million through cash flow at the parent and now stands at just 1.9 times trailing 12-month EBITDA. Our debt-to-cap ratio is about 43%. We continue to have ample cash and access to capital to fuel our growth initiatives. Days in claims payable at the end of the quarter was $43 million. significantly lower than prior quarters, driven by several items.

本季末的債務透過母公司的現金流減少了約 2 億美元，目前僅為過去 12 個月 EBITDA 的 1.9 倍。我們的債務與資本比率約為43%。我們繼續擁有充足的現金和資本來推動我們的成長計劃。本季末應付理賠天數為 4,300 萬美元，受多項因素影響，顯著低於前幾季。

Recall the DCP calculation compares to fee-for-service components of our IBNR balance to the average daily medical claims expense. By quarter end, larger-than-normal cash payments significantly reduced the IBNR balances driven by faster processing and adjudication of claims as well as several large discrete cash settlements of age liabilities. Normalizing for these items, our DCP is more in line with historical averages.

回想一下，DCP 計算將我們的 IBNR 餘額的按服務收費部分與平均每日醫療索賠費用進行了比較。到季度末，由於索賠處理和裁決速度加快，以及幾筆大額離散現金結算年齡負債，高於正常水平的現金支付顯著減少了 IBNR 餘額。在這些項目進行標準化後，我們的 DCP 更符合歷史平均值。

As some of these items are sustaining we guide to lower DCPs in the mid-40s in future periods. We remain confident in the strength of our actuarial process and our reserve position. Next, a few comments on our 2025 guidance. We continue to expect full year premium revenue to be approximately $42 billion. Our adjusted earnings guidance is no less than $19 per share.

由於其中一些項目正在持續上漲，我們預計未來時期 DCP 將下降至 40 年代中期的水平。我們對我們的精算流程和儲備狀況的實力仍然充滿信心。接下來，我們對 2025 年的指導提出幾點評論。我們仍然預計全年保費收入約為 420 億美元。我們的調整後獲利預期不低於每股 19 美元。

Within our guidance, the full year consolidated MCR increases to 90.2%, up 140 basis points from our initial guidance at $24.50. As Joe mentioned, the higher MCR is disproportionately driven by marketplace. Marketplace is just 10% of our premium revenue yet accounts for almost half of the consolidated increase in MCR.

在我們的指引範圍內，全年合併MCR將升至90.2%，較我們最初的24.50美元指引高出140個基點。正如Joe所說，較高的MCR主要受市場驅動。市場僅占我們保費收入的 10%，但卻佔 MCR 綜合成長的近一半。

In Medicaid, we are raising the full year MCR guidance from 89.9% to 90.9% as trend is now expected to exceed rates. With the observed trend in Q2, and our expectations for higher trend over the rest of the year. We are updating our full year-over-year trend outlook from 5% to 6%. The Updated rates in several states increased our full year-over-year rate only modestly from 5% to a little higher than 5%.

在醫療補助方面，我們將全年 MCR 指導從 89.9% 提高到 90.9%，因為現在預計趨勢將超過比率。根據第二季觀察到的趨勢，我們預計今年剩餘時間的趨勢將會提高。我們將全年同比趨勢預測從 5% 更新為 6%。幾個州的更新後的稅率僅使我們的全年同比稅率從 5% 小幅上升至略高於 5%。

We have several known on-cycle rates time for Q3 and Q4. And recognizing higher experience trends. We continue to see a willingness from states to discuss off-cycle and retro rate adjustments as data develops. but we do not include speculative off-cycle rate updates in our guidance. In the second half of the year, ongoing medical cost pressure will exceed known rate updates.

我們知道 Q3 和 Q4 的幾個週期利率時間。並認識到更高經驗的趨勢。隨著數據的發展，我們繼續看到各州願意討論非週期和追溯利率調整。但我們的指導中不包括投機性的非週期利率更新。下半年，持續的醫療成本壓力將超過已知的費率更新。

As such, we expect our Medicaid MCR of 90.8% in the first half to increase to 91% in the second half of the year. Even at these MCR guidance levels higher than our long-term target range, our Medicaid segment full year pretax guidance margin is approximately 3.5%, demonstrating the underlying strength of this segment even in this challenging operating environment.

因此，我們預計醫療補助 (Medicaid) 上半年的 MCR 為 90.8%，下半年將升至 91%。即使這些 MCR 指導水準高於我們的長期目標範圍，我們醫療補助 (Medicaid) 部門全年稅前指導利潤率仍約為 3.5%，這體現了該部門即使在當前充滿挑戰的營運環境中依然保持著強大的實力。

In Medicare, we are increasing our full year MCR guidance from 89% to 90%, reflecting higher utilization among our high-acuity duals membership. We expect our Medicare first half MCR of 89.2% to increase to 90.9% in the second half of the year, driven by our outlook on trends, normal medical cost seasonality and the new inpatient facility fee schedule in the fourth quarter.

在醫療保險方面，我們將全年 MCR 指引從 89% 提高到 90%，這反映了我們的高敏銳度雙重會員的更高利用率。我們預計，受趨勢展望、正常醫療成本季節性以及第四季度新的住院設施收費表的影響，今年上半年 Medicare MCR 將從 89.2% 增加到下半年的 90.9%。

The Medicare segment full year pretax guidance margin is approximately 1.5%. Looking forward to 2026, we believe the final rate notice and our product designs, which we filed in May captured this higher 2025 jumping off point for our 2026 bids. In marketplace, we are increasing our full year MCR guidance from 80 to 85. The full year Marketplace MCR now includes approximately 200 basis points attributable to the combination of prior year member reconciliations and the new store impact of ConnectiCare.

醫療保險部門全年稅前指導利潤率約 1.5%。展望 2026 年，我們相信，我們在 5 月提交的最終利率通知和產品設計抓住了 2025 年這一更高的起點，為我們 2026 年的投標奠定了基礎。在市場上，我們將全年 MCR 指導從 80 提高到 85。全年 Marketplace MCR 目前包括約 200 個基點，這歸因於上一年會員對帳和 ConnectiCare 新店影響的結合。

Excluding these items, the normalized full year Marketplace MCR is approximately $83 million. We expect the normalized Marketplace MCR of $80 million in the first half of the year to increase to approximately $86 million in the second half of the year, reflecting higher observed trends and normal seasonal patterns for marketplace. While we are disappointed with these results for Marketplace, I will note that even with an expected full year reported MOR of approximately $85 million we would achieve low single-digit pretax margins in this business.

除這些項目外，全年標準化市場 MCR 約為 8,300 萬美元。我們預計，上半年市場 MCR 的正常化水準為 8,000 萬美元，下半年將增至約 8,600 萬美元，這反映了市場觀察到的更高趨勢和正常的季節性模式。雖然我們對 Marketplace 的這些結果感到失望，但我要指出的是，即使預計全年報告的 MOR 約為 8500 萬美元，我們在該業務中的稅前利潤率也只能達到較低的個位數。

The Marketplace segment full year pretax guidance margin is approximately 1% or 3% normalized for the items I have detailed. We believe we can capture this trend pressure in our 2026 marketplace pricing with additional conservative assumptions included for the expiration of enhanced subsidies, new program integrity policies, and the related potential acuity shift in the market risk pool.

對於我所詳述的項目而言，市場部門全年稅前指導利潤率約為 1% 或 3%。我們相信，我們可以在 2026 年的市場定價中捕捉到這種趨勢壓力，並加入額外的保守假設，包括增強補貼的到期、新的計劃完整性政策以及市場風險池中相關的潛在敏銳度轉變。

Given our relatively low exposure to marketplace at just 10% of our current portfolio revenue mix, we can remain focused on producing mid-single-digit pretax margins. We will prioritize margin and let membership fall where it may. We now expect the full year G&A ratio to be approximately 6.6% better than previously guided by 30 basis points, reflecting the very low second quarter expense and continued efficiencies in our operations.

鑑於我們對市場的曝險相對較低，僅占我們目前投資組合收入組合的 10%，我們可以繼續專注於實現中等個位數的稅前利潤率。我們將優先考慮利潤，並讓會員人數隨意減少。我們現在預計全年一般及行政開支比率將比先前預測的高出 30 個基點，達到約 6.6%，這反映了第二季度的極低開支和我們營運的持續高效。

Our full year EPS guidance is now expected to be no less than $19 per share lower than our first quarter guidance by $550 million. Guidance now includes $8 for our updated full year MCR outlook, partially offset by $250 million from the improved G&A ratio and slightly higher investment income given the fewer Fed rate cuts now expected.

我們現在預計全年每股盈餘指引將比第一季指引低不少於 19 美元，即 5.5 億美元。目前，我們更新後的全年 MCR 預期中包括 8 美元，但由於預計聯準會降息次數減少，G&A 比率改善導致的 2.5 億美元和投資收入略有增加，部分抵消了這一影響。

Our consolidated guidance pretax margin is expected to be approximately 3.1% despite the significant dislocation of rates and trends with 55% of our revenue renewing on January 1 of next year, our rate cycle is well timed for 2026.

儘管利率和趨勢出現重大錯位，且我們 55% 的收入將於明年 1 月 1 日更新，但我們的綜合指導稅前利潤率預計約為 3.1%，我們的利率週期對於 2026 年來說時機恰到好處。

This concludes our prepared remarks. Operator, we are now ready to take questions.

我們的準備好的演講到此結束。接線員，我們現在可以回答問題了。

(Operator Instructions)

（操作員指示）

Andrew Mok from Barclays.

巴克萊銀行的 Andrew Mok。

Hi, good morning you noted that the back half Medicaid MLR is higher than the first half, but it looks like there's some modest improvement from the 2Q MLR. How do you get confidence that Medicaid margins will improve from here when the spot rate for reimbursement seems to be inadequate in an inflationary trend environment and newer redeterminations and integrity measures look like they may impact both membership and risk pool on a go-forward basis? Thanks.

您好，早安，您注意到後半部分醫療補助 MLR 高於前半部分，但看起來第二季 MLR 有所改善。在通膨趨勢環境下，當即期報銷利率似乎不足，而較新的重新確定和誠信措施似乎可能會對會員資格和風險池產生影響時，您如何確信醫療補助利潤率將從現在開始改善？謝謝。

Yeah, good morning, Andrew, it's Mark. In the first half, we reported a 90.8% and my guidance implies a 91% for the second half of the year. Essentially, what we have is trend slightly outstripping the rates that we know about, which is why we have a little upward pressure on that. Now the good news is our previous guidance already had a bunch of rate manifesting in Q3 and Q4. We didn't get much more.

是的，早上好，安德魯，我是馬克。上半年，我們的報告顯示其銷售額達到 90.8%，而我的預期是下半年銷售額將達到 91%。本質上，我們所看到的趨勢略微超過了我們所知的利率，這就是為什麼我們對此有一點上行壓力。現在的好消息是，我們之前的指引已經在第三季和第四季體現出一系列利率。我們沒有得到更多。

I originally thought second half would be better than this. So we are factoring in that observed trend. On the other issue you mentioned there's the news plan around about the duplicative members in marketplace and or Medicaid.

我原本以為下半場會比這更好。因此，我們正在考慮觀察到的趨勢。關於您提到的另一個問題，有關於市場和醫療補助中重複成員的新聞計劃。

If you look, I think they're saying it's about 2.8% of the combined Medicaid and Marketplace pool, which we think there's a lot of errors in the numbers, and I think it's also going to take a long time to play out. I don't see that as being a meaningful membership headwind this year. So to me, it's all about the relationship of rates and trends. And we already had a lot of rate back in for us. This trend keeps coming, and we're going to model it like it is.

如果你看一下，我認為他們說的是醫療補助和市場資金池總額的 2.8% 左右，我們認為這些數字存在著許多錯誤，而且我認為這也需要很長時間才能實現。我不認為這會成為今年會員人數減少的重大阻力。所以對我來說，這完全是關於利率和趨勢的關係。我們已經收回了很多利率。這種趨勢仍在繼續，我們將對其進行建模。

Great. Maybe just a follow-up on the ACA, as you look to refile the rates, is there a number you have in mind for the required premium increases next year to properly account for all the trend in risk pool issues across both '25 and '26 and reset to a normalized margin?

偉大的。也許只是對 ACA 的後續關注，當您希望重新提交費率時，您是否考慮了明年所需的保費增長數字，以正確考慮 '25 和 '26 年風險池問題的所有趨勢並重置為正常化利潤率？

We're not we're not going to disclose our rate filing state by state. But I will tell you, the rate model is very clearly, first, have to catch up with the underperformance this year to get it back to mid-single-digit target margins. Second, a healthy dose of medical cost trend. Bear in mind, we've increased our assumption this year on medical cost trend year-over-year from 7% to 11%.

我們不會逐州揭露我們的稅率申報情況。但我會告訴你，利率模型非常明確，首先，必須趕上今年的表現不佳，以使其回到中等個位數的目標利潤率。二是醫療費用趨勢向好。請記住，我們今年對醫療成本趨勢的假設已從 7% 提高到 11%。

And you can rest assured we're putting a healthy dose of trend into rates. And then thirdly, the acuity shift that's going to occur next year due to the expiration of the APTCs, Again, modeled conservatively a healthy dose of conservatives and put into rates. But we're not going to go state by state, but we've captured all the elements that need to be captured. And we don't expect the business to grow next year. The market will shrink and we're not looking to grow.

您可以放心，我們正在將健康的趨勢納入利率中。第三，由於 APTC 到期，明年將發生敏銳度轉變，再次，保守地模擬了適量的保守派並將其納入利率。但我們不會逐州進行調查，但我們已經掌握了所有需要掌握的要素。我們預計明年業務不會成長。市場將會萎縮，我們並不希望成長。

We're looking to get back to mid-single-digit target margins, having rated up for all the elements that are going to impact next year.

我們希望回到中等個位數的目標利潤率，並對所有將影響明年的因素進行評級。

Josh Ruskin from Nephron Research.

Nephron Research 的 Josh Ruskin。

Yeah, thanks. I guess the question on the marketplace would be in light of the trends developing even worse, just the last couple of weeks, how much adjustment to your marketplace pricing cap should be done at this point to the states from the Fed Exchange? Do they allow significant adjustments at this point? And maybe when is the last time you could submit pricing changes for 2026?

是的，謝謝。我想市場上的問題是，鑑於過去幾週的趨勢進一步惡化，聯邦交易所應該對各州的市場定價上限進行多少調整？他們現在允許進行重大調整嗎？也許您上一次提交 2026 年價格變更是什麼時候？

Yeah, hey, Josh, yes, the states are adding a lot of flexibility this year. In past years, it was pretty hard and fast when the deadlines are. This year, every state is a little bit different, but there is either new deadlines even through August or there's soft kind of rolling discussions about where we are.

是的，嘿，喬希，是的，各州今年增加了很多靈活性。在過去的幾年裡，截止日期是相當嚴格的。今年，每個州的情況都有些不同，但甚至到八月份都有新的截止日期，要么就我們所處的階段進行溫和的滾動討論。

Now some states also parse things a little bit differently. Can you change your trend assumption year-to-year just on core utilization that might be harder than can you change your assumption for acuity shift as more data evolves.

現在有些州對事情的解析也略有不同。您能否僅根據核心利用率逐年改變趨勢假設，這可能比隨著更多數據的發展而改變敏銳度轉變的假設更難。

So it's a little bit about what components of pricing are changing. States view the components differently on where the flexibility is. But that's an ongoing discussion. And you have to appreciate that states need to be a little bit accommodating here, because the last thing they want is folks to drop out. They need to be accommodating on pricing because it's part of a sustaining market.

所以這有點關於定價的哪些組成部分正在改變。各州對於彈性所在部分的看法不同。但這是一個仍在繼續討論的問題。你必須意識到各州需要在這方面稍微通融一下，因為他們最不希望看到的就是人們退出。他們需要在定價上做出讓步，因為這是持續市場的一部分。

Yeah, that makes sense. But I guess I'm just sort of thinking about your comments last quarter and the quarter before, where you spoke about a more stable marketplace membership. You talked about higher retention this year. So I guess I'm just still struggling with, what do you think is the root cause of this pickup in utilization and now, I guess, market-wide?

是的，這很有道理。但我想我只是在思考您上個季度和上個季度的評論，您當時談到了更穩定的市場會員資格。您談到了今年更高的保留率。所以我想我仍然在努力思考，您認為導致利用率上升的根本原因是什麼，我想現在整個市場都是如此？

It is market-wide. And as demonstrated by the Wakely analysis that the risk pool as deteriorated by 8% year-over-year. The acuity of the entire marketplace risk pool is higher by 8% year-over-year, which means on a relative basis, risk adjustment is not going to keep up with the elevated trend. As I said, we've increased our trend assumption from 7% that went into pricing to 11% in our forecast.

它是整個市場的。Wakely 分析表明，風險池比去年同期下降了 8%。整個市場風險池的敏銳度比去年同期上升了 8%，這意味著相對而言，風險調整不會跟上上升的趨勢。正如我所說，我們已將趨勢假設從定價中的 7% 提高到預測中的 11%。

And as I said, all we can do is put a healthy dose of trend into next year's rates, catch-up adjustment acuity adjustment, and we feel confident that we'll get back to mid-single-digit margins at the expense of growth. But there's no other explanation except that the Marketplace risk pool nationally is higher acuity, wake estimate 8% higher this year than last.

正如我所說，我們所能做的就是在明年的利率、追趕調整敏銳度調整中加入健康的趨勢，我們有信心，我們將以犧牲增長為代價，恢復到中等個位數的利潤率。但除了全國市場風險池敏銳度更高（預計今年比去年高出 8%）之外，沒有其他解釋。

Stephen Baxter from Wells Fargo.

富國銀行的史蒂芬‧巴克斯特。

Hi, thanks. Just another couple on the exchanges. I guess, I know you're not going to give specific rate increases or request by state. But I guess just big picture, like how are you thinking about market-wide enrollment decline in 2026, obviously, that's a key component of forecasting acuity correctly.

你好，謝謝。這只是交易所裡的又一對情侶而已。我想，我知道您不會給予具體的加息幅度或各州的要求。但我想只是從大局來看，例如您如何看待 2026 年整個市場的入學人數下降，顯然，這是正確預測敏銳度的關鍵因素。

And I guess, is it fair to say that the acuity shift that you're putting into pricing is going to be multiples of the acuity shift we're seeing this year. And ultimately, if you do have states that don't let you take the rate increases that you want, like how do you plan to respond? Thanks.

我想，可以公平地說，您在定價中考慮的敏銳度變化將是我們今年看到的敏銳度變化的數倍。最後，如果有些州不允許您按照自己的意願提高利率，您打算如何應對？謝謝。

Mark,

標記，

Yeah, So a couple of things. We're hesitant to talk about specific acuity adjustments or member shifts just because this is a competitive market, and you can imagine that, that's something everyone needs to do independently. The other thing, though, is it varies so much by state. There are national averages for trend for acuity shift from the subsidies from acuity shift from program integrity.

是的，有幾件事。我們不願意談論具體的敏銳度調整或會員轉變，因為這是一個競爭激烈的市場，你可以想像，這是每個人都需要獨立完成的事情。但另一件事是，不同州的情況差異很大。全國範圍內存在從補貼到項目完整性敏銳度轉變的趨勢平均值。

But the dynamic state by state are so different. One of the things you have to look at is some of these states didn't grow their marketplace meaningfully from pre-pandemic. So they're not in a different place. but it also really matters what is the distribution of metallic cohorts? What is the distribution of federal poverty level cohorts? And then finally, what states expanded, which ones didn't.

但各州的動態差異很大。你必須關注的一點是，其中一些州的市場規模與疫情前相比並沒有顯著成長。所以它們並不在不同的地方。但金屬群的分佈也確實很重要嗎？聯邦貧窮水平群體的分佈如何？最後，哪些州擴張了，哪些州沒有擴張。

All those things mean that some states will have very material declines in marketplace. Other ones will be quite subtle because things aren't that meaningfully different under the new rules.

所有這些都意味著一些州的市場將大幅下滑。其他問題將會非常微妙，因為新規則下事情並沒有太大的不同。

So look, we have to go about this and price state by state, very specifically. In some cases, the numbers are big and in some cases, not so much. And related to the acuity shift, which is the wildcard for next year, it will be interesting to see how all the market participants reacted that we have very intricate models trying to assess what the elasticity of demand is around $1 differential in price, looking at whether we're number 1, 2, 3 or 4 in that market and where the competitors were last year is a bronze product available in that market.

所以，我們必須非常具體地處理這個問題，並根據各州的具體情況來制定價格。在某些情況下，數字很大，而在某些情況下，數字則不那麼大。與敏銳度轉變（這是明年的未知數）相關，有趣的是，看看所有市場參與者如何反應，我們有非常複雜的模型試圖評估需求彈性在 1 美元左右的價格差異，看看我們是否是該市場的第一、第二、第三或第四名，以及去年競爭對手在該市場上是否有青銅產品。

So a lot of factors go into it. As I said, all you can do is lean on the assumptions approach it conservatively when it comes to the acuity adjustment and the our state-based partners are absolutely willing to give us a second pass rate filing to use the latest information, which should mitigate any mispricing risk.

所以有很多因素都會影響它。正如我所說，您所能做的就是在進行敏銳度調整時依靠假設採取保守的方法，而我們位於州的合作夥伴絕對願意為我們提供第二次通過率申報以使用最新信息，這應該可以減輕任何錯誤定價風險。

Justin Lake from Wolfe Research.

來自 Wolfe Research 的 Justin Lake。

Thanks, good morning first question is around run rate earnings. It looks like the back half is around $750 million that you've talked about and even seen historically about even split, give or take, of first half to second half. So you look like you're run rating at about $15 a share in the back half of the year.

謝謝，早上好，第一個問題是關於運行率收益。看起來後半部分約為 7.5 億美元，正如您所談論的，甚至在歷史上也看到過，前半部分和後半部分的比例大致相等。因此，看起來您下半年的運行評級約為每股 15 美元。

Curious if that's a reasonable way to think about it in your mind? And if so, how does that bias us to think about your ability to grow earnings year-over-year into 2026?

好奇在您看來這是否是合理的思考方式？如果是這樣，這會對我們思考你們在 2026 年實現盈利逐年增長的能力產生什麼影響？

Well, I think that is the run rate math. Bear in mind that over half our Medicaid revenue has a one by one renewal cycle. We're advocating very hard for adequate rates for one by one. And making sure our state partners use the most reasonable and recent baseline. We're advocating for July of '24 to July '25 as the baseline, which is really important takes a lot of risk out of what the jumping off point that you trend off of.

嗯，我認為這就是運行率數學。請記住，我們的醫療補助收入有一半以上都有一個逐一的更新周期。我們正在極力主張為每一個人提供適當的利率。並確保我們的州合作夥伴使用最合理和最新的基線。我們主張以 2024 年 7 月至 2025 年 7 月為基準，這非常重要，可以消除趨勢起點帶來的許多風險。

So we're optimistic about the one by one rate cycle for '26. Of course, we have one by three of embedded earnings that are going to emerge in 2026, including the $1 of implementation cost that just disappears. But too early to make a call in 2026, but that is the back half of half about $15 a share, but we feel good about the pricing cycle for marketplace, I feel pretty good about the rate cycle for 1-1-'26 in Medicaid. And then, of course, we have embedded earnings. But far too early to make a call in 2026, we'll have to wait till the third or the fourth quarter to do that. Mark, anything to add?

因此，我們對 26 年的逐一利率週期持樂觀態度。當然，我們有三分之一的嵌入式收益將在 2026 年出現，其中包括剛消失的 1 美元實施成本。但在 2026 年做出判斷還為時過早，但那是每股約 15 美元的後半部分，但我們對市場的定價週期感到滿意，我對 1-1-'26 醫療補助的利率週期感到非常滿意。當然，我們還有嵌入式收益。但現在就預測2026年的情況還為時過早，我們得等到第三季或第四季才能知道。馬克，還有什麼要補充的嗎？

Just is your math is good, roughly $750 million in the second half, but you can't just double it for next year for all the reasons Joe mentioned. Again, the rate cycle is just critical for January 1. And the industry needs these rates more than Molina does at the moment. The industry is very underfunded. We need money just to get back to target margins. So we should see a lot of progress on the rate cycle for January 1.

只是你的數學很好，下半年大約是 7.5 億美元，但你不能因為喬提到的所有原因而將明年的數字翻一番。再次強調，利率週期對於 1 月 1 日來說至關重要。目前，該行業比莫利納更需要這些利率。該行業資金嚴重不足。我們需要資金才能回到目標利潤率。因此，我們應該會看到1月1日的利率週期取得巨大進展。

And then lastly, as Joe mentioned, we're hiring at $865 million of embedded earnings. We had previously guided to seeing about one by third of it next year. We'll update that as we see the rate cycle and everything else coming forward. But as Joe mentioned, if the guidance is one by three of that for next year, $1 of it is guaranteed. It's just the reversal of the implementation fees we carry this year.

最後，正如喬所提到的，我們招募的嵌入收益為 8.65 億美元。我們之前曾預測明年會看到大約三分之一的景象。隨著利率週期和其他所有情況的進展，我們將更新該資訊。但正如喬提到的那樣，如果明年的指導價是這個數字的三分之一，那麼其中的 1 美元是可以保證的。這只是我們今年所承擔的實施費用的逆轉。

So too soon to give guidance for next year, but I think those are the building blocks in the setup for next year.

現在對明年做出預測還為時過早，但我認為這些是明年的基礎。

The last comment I'll make on the back half is, when we closed out the second quarter. It became obvious to us that quarterly trend in Medicaid had again accelerated, trended in the first quarter of the fourth was 1.2%. That's just a quarterly trend when we closed out June it's 1.6%, just a quarterly trend. We of course, you have a decision to make, how conservative you want to be for the back half. We repeated that 1.6% Medicaid trend in each of Q3 and Q4.

我對後半部分的最後一條評論是，當我們結束第二節時。我們發現，醫療補助的季度趨勢再次加速，第四季第一季的趨勢為 1.2%。這只是 6 月結束時的一個季度趨勢，即 1.6%，只是一個季度趨勢。當然，你必須做出決定，對於後半部你想採取多大的保守態度。我們在第三季和第四季都重複了 1.6% 的醫療補助趨勢。

So whether it proves to be conservative or not or enough remains to be seen, but we used the last data point, which is the highest quarterly trend we've observed in the last four and projected it forward.

因此，它是否被證明是保守的或足夠的還有待觀察，但我們使用了最後一個數據點，這是我們在過去四個季度中觀察到的最高季度趨勢，並將其預測到未來。

Thanks. And then just a couple of quick numbers questions. First, the SG&A benefit for the year from lower comp executive comp that probably comes back next year, if it's possible to put a number on that, that would be helpful. If I missed it, I apologize, but I heard Steve ask what you think the exchanges decline by next year in terms of membership. I didn't hear an answer there?

謝謝。然後只是幾個簡單的數字問題。首先，今年來自較低薪酬高階主管薪酬的銷售、一般和行政管理費用收益可能會在明年回歸，如果可以確定一個數字，那將會很有幫助。如果我錯過了，我很抱歉，但我聽到史蒂夫問你認為明年交易所的會員數量會下降多少。我沒有聽到那裡的回答？

So a couple of things there. Our original G&A guidance was $6.9 million way back at the beginning of the year. We're currently guiding to $6.6 million and a meaningful part of that is the onetime or the management compensation that came out in the second quarter.

那裡有幾件事。我們年初制定的 G&A 指導價為 690 萬美元。我們目前的預期是 660 萬美元，其中很大一部分是第二季發放的一次性管理薪資。

Now if you're going to, how do I think about the setup for next year yes, that management compensation piece comes back next year as potentially a G&A headwind. The good news is it's offset by that implementation cost that's in our G&A that go away for next year, right?

現在，如果您要問，我該如何考慮明年的安排？是的，管理薪酬部分明年可能會再次成為 G&A 方面的阻力。好消息是，它可以被我們明年的一般及行政費用中的實施成本所抵消，對嗎？

So those 2 offset, which if I were modeling a G&A number for next year, it would be a little better than $6.9 million, call it, $6.8 million, and we'll see how that evolves. But I think that's the ZIP code. Now on Marketplace membership, we're not here to give projections on the market and specifically not on our own member base.

因此，如果我為明年的 G&A 數字建模，那麼這兩個抵消額會比 690 萬美元好一點，就叫它 680 萬美元吧，我們將看看它如何發展。但我認為那是郵遞區號。現在關於市場會員資格，我們並不是來對市場做出預測的，特別是對我們自己的會員基礎的預測。

Some pundits out there have kicked around numbers of a roughly 30% decline you can make an argument for why it's more. You can make an argument for why it's less. We need to take our own views internally and why that's critical is linked to the membership decline is the acuity shift. So we're working through that right now, as you can imagine.

一些專家給出了大約 30% 的降幅，您可以解釋為什麼降幅更大。您可以爭論為什麼它更少。我們需要在內部形成自己的觀點，而這一點之所以至關重要，是因為會員人數的下降與敏銳度的轉變有關。所以正如你所想像的，我們現在正在努力解決這個問題。

And given that it's only 10% of the portfolio, we have far more optionality and flexibility than many others in the market. We'd like to keep it at 0, but if it becomes lower in order to get to mid-single-digit margins, that's the way it's going to be.

鑑於它僅佔投資組合的 10%，我們比市場上的許多其他公司擁有更多的選擇性和靈活性。我們希望將其保持在 0，但如果為了達到中等個位數的利潤率而將其降低，情況就會是這樣。

AJ Rice from UBS.

瑞銀的 AJ Rice。

Think about second half of this year versus potentially first half of next year. I know you've got 55% of your rate or your book resets and rates if I think about where you're at on margin for first half of this year versus and then second half, I assume when you came into the year, you assumed a step-up in our performance in the second half of this year. That doesn't seem like it's material.

想想今年下半年與明年上半年的可能性。我知道您的利率或帳簿重置和利率已經達到了 55%，如果我考慮今年上半年和下半年的利潤率，我假設當您進入今年時，您認為我們下半年的業績會有所提升。這看起來不像是實質的東西。

I'm trying to understand how much of a hole you have when you compare first half of this year against you're jumping off point for first half next year. Are you dependent on those rate updates to even get back to where you had in the first half of the year? Or would that be a step forward to getting to your target margins, if you understand what I'm trying to ask.

我想了解的是，當你將今年上半年與明年上半年的起點進行比較時，你的差距有多大。您是否依賴這些利率更新來恢復到上半年的水平？或者，如果您明白我的意思，這是否會成為您實現目標利潤的一步？

Yeah, I think I do, AJ it's a matter of degree. So clearly, we're disappointed in our outlook for the second half of the year. rates that should have been good enough to carry us through the year for our expectations are now woefully short of how trend is emerging, which is why we have a significantly lower second half of the year than the first. Now for the setup of next year, as Joe mentioned, 55% of the revenue on January 1, we clearly need the rate cycle to help us get back to our normal target margins.

是的，我認為是這樣，AJ，這只是程度的問題。顯然，我們對下半年的前景感到失望。利率本來應該足以讓我們度過今年的預期，但現在卻遠低於目前的趨勢，這就是為什麼下半年的利率遠低於上半年。現在對於明年的安排，正如喬所提到的，1 月 1 日的收入為 55%，我們顯然需要利率週期來幫助我們恢復到正常目標利潤率。

The question is how much will we see and how does it manifest? I'm also somewhat encouraged that there will be some off cycles along the way that juice that 55% of revenue a little further, but we're just not going to project those for right now. Does that help?

問題是我們會看到多少以及它將如何體現？我也感到有些鼓舞，因為在這個過程中會有一些非週期性波動，從而進一步提高 55% 的收入，但我們現在還不打算對這些波動進行預測。這樣有幫助嗎？

Yeah. I think I'm just trying to figure out I don't think you were to target margins in the first half of the year. So just how much of a hole are you starting on the year-to-year comparison before you take into the rate updates or they move you forward, you just might not get to pull target margins in the first half of '26, but.

是的。我想我只是想弄清楚，我認為你不應該在上半年設定利潤目標。那麼，在考慮利率更新或利率調整之前，逐年比較時你的虧損到底有多大？你可能無法在 26 年上半年達到目標利潤率，但是。

They definitely move us forward. It's just a matter of to what degree we get them. If the industry is funded to where it needs to be, we'll be well back into the target margins even paying into corridors again. So it's just a matter of how quickly do states move back to what is actuarially appropriate.

他們確實推動了我們前進。問題只是我們能獲得多少它們。如果該行業獲得所需的資金，我們將回到目標利潤率，甚至再次支付走廊費用。因此，問題只是各州多快恢復到精算上適當的水平。

Okay. Just the other thing I wanted to ask you about is I appreciate the comments about the budget bill. I think there's and the 15% to 20% of the expansion population, that could be at risk under the work rules. Any comments about how that might affect the underlying acuity or risk pool and whether we're going to be dealing with another Medicaid redetermination type of phenomenon there.

好的。我想問您的另一件事是，我很感謝預算法案的評論。我認為，根據工作規則，擴張人口中的 15% 到 20% 可能會面臨風險。關於這可能會如何影響潛在的敏銳度或風險池以及我們是否會在那裡處理另一種醫療補助重新確定類型的現象，您有何評論？

And you didn't mention the issue of the undocumented immigrants that are getting covered in some of the states, some I know you have exposure to, how meaningful an issue is that, if they eliminate federal funding for that Medicaid population.

你沒有提到一些州為無證移民提供醫療補助的問題，我知道你接觸過一些州的情況，如果他們取消對這些醫療補助人群的聯邦資助，這個問題會有多麼嚴重？

First, with respect to the risk pool, we believe this will happen in a gradual manner. A state would be well served not to have a shop loss. They can't be dealt with either administratively or from an acuity perspective. We have looked at all of our cohorts by age, duration, geography, et cetera, for our expansion population.

首先，關於風險池，我們認為這將逐步實現。如果商店不遭受損失，對州來說就更好了。無論從行政角度或敏銳度角度，都無法處理這些問題。我們根據年齡、持續時間、地理位置等因素對所有群組進行了分析，以確定我們的擴展人群。

And the MCR skewers the way it skewed are not significant. Now you start with the premise that if people need insurance, they're going to keep it and people who we don't need it. So there will be a little bit of a shift there. but the SKUs by cohort are not so significant and the fact that we believe it will happen gradually gives us comfort that it can ease into the rate cycle without a seismic shift the way the three year pause on the redetermination process caused the risk pool to shift initially.

且 MCR 的傾斜方式並不顯著。現在，你首先要有一個前提：如果人們需要保險，他們就會保留它，而那些不需要保險的人則不會。因此，那裡會有一點點轉變。但按群組劃分的 SKU 並不那麼重要，而且我們相信它會逐漸發生，這一事實讓我們感到欣慰，它可以輕鬆地進入利率週期，而不會像重新確定過程的三年暫停導致風險池最初轉移那樣發生劇烈轉變。

And just so there's no confusion, AJ, the 15% to 20% we're talking about is of the expansion population, not the Medicaid book. So this is a dramatically lower impact and potential decline than the broader REIT debt that we experienced over the last couple of years.

為了避免混淆，AJ，我們談論的 15% 到 20% 是指擴張人口，而不是醫療補助簿中的人口。因此，與我們過去幾年經歷的更廣泛的房地產投資信託債務相比，這的影響和潛在下降幅度要小得多。

On the second question about undocumented immigrants, we have about five states where they are in the program, but it's very, very minor. The one state where there's a significant number, where we are a player is California. We have we are working to continue to figure out how they're going to handle that, cover them or not. Obviously, the FMAP match reduction if they do decide to cover them, disappeared in the final budget bill. So that's not a factor.

關於第二個問題，關於無證移民，我們有大約五個州參與了該計劃，但數量非常少。其中一個數量可觀且我們是參與者的州是加州。我們正在努力繼續弄清楚他們將如何處理這個問題，無論是否要報道他們。顯然，如果他們決定支付 FMAP 匹配費用，那麼這筆費用將在最終預算法案中消失。所以這不是一個因素。

But the only state that's material to us to the program is California, and we're monitoring that closely, but no answers at this point.

但對於我們的計劃來說，唯一重要的州是加州，我們正在密切關注，但目前還沒有答案。

Kevin Fischbeck from Bank of America.

美國銀行的 Kevin Fischbeck。

Great. Just wanted to see, if you guys have a better understanding of why trend is so elevated across all of these products. I know you already mentioned kind of the buckets that they're elevated in. But is there something driving that this year that would give you confidence or optimism that these trends will start to moderate in future years. It's just not clear to me why we're so instantly high, and therefore, it's hard to forecast how much margin improvement we should be forecasting?

偉大的。只是想看看，你們是否更了解為什麼所有這些產品的趨勢都如此高漲。我知道你已經提到它們被放置在什麼樣的桶子裡。但是，今年有什麼因素會讓您有信心或樂觀地認為這些趨勢在未來幾年會開始緩和。我只是不清楚為什麼我們的利潤率會立即這麼高，因此很難預測我們應該預測多少利潤率的提高？

Interesting question. We have really we have our arms around the what. I think the industry generally doesn't have their arms around the why. I mean you go cost component by cost component for behavioral, the prevalence of behavioral conditions is up, so the prevalence is higher. The stigma around getting services has begun to disappear in older populations that existed in younger populations it doesn't.

有趣的問題。我們確實已經掌握了一切。我認為業界普遍不清楚原因。我的意思是，如果你逐一查看行為成本組成部分，你會發現行為狀況的盛行率上升了，因此盛行率也更高。在老年人群中，獲得醫療服務的恥辱感已經開始消失，而在年輕人群體中則不存在這種恥辱感。

States have encouraged us to widen our networks. People did not go for services during the pandemic and now they are. So there's some pent-up demand.

各國鼓勵我們擴大我們的網絡。疫情期間人們沒有去尋求服務，但現在他們就去了。因此存在一些被壓抑的需求。

But I could go cost category by cost category, and it's a supply and demand side equation. The supply side is finding interesting ways to code, to bundle codes, et cetera, using AI, et cetera. So there's a myriad of reasons, why the demand is higher and the supplies were rich, but it's happening nationally, and it's not just Medicaid, it's not just Medicare. It's in commercial population, self-insured population that's across the board.

但我可以逐一分析成本類別，這是供需方方程式。供應方正在尋找有趣的方式來編碼、捆綁代碼等等，使用人工智慧等等。因此，需求更高、供應豐富的原因有很多，但這種情況在全國範圍內發生，不僅僅是醫療補助，也不僅僅是醫療保險。它涉及商業人口和自我保險人口的各個方面。

Okay. And then maybe just the second question would just be on timing because I think that these rate cycles go through and they're still always on a lag. I mean do you believe that when you get these rate updates, you'll be at in that target margin range next year? Does it take more rate cycle?

好的。然後也許第二個問題只是關於時間，因為我認為這些利率週期會經歷並且它們總是滯後。我的意思是，您是否相信當您獲得這些利率更新時，您明年的利潤率就會達到目標範圍？是否需要更多的利率週期？

It just seems like the risk pool is continuing to shift underneath everything and that you'll get the rate cycle to reflect last year's cost. But this year's cost will be high. This year's cost will still see risk pool shifts. So like do you ever catch up? And then I guess separately, but similarly, on that embedded earnings power number, you reaffirm the number, but do you still feel like you'll capture it in the same time period?

看起來風險池正在一切事物之下持續轉移，而利率週期將反映去年的成本。但今年的成本會很高。今年的成本仍將出現風險池的轉移。那你有沒有趕上？然後我想，單獨但類似地，在那個內含盈利能力數字上，你重申了這個數字，但你是否仍然覺得你會在同一時間段內捕捉到它？

Or is that time period stretching out a little bit because of these underlying risk pool shifts? Thanks.

或者由於這些潛在的風險池轉移，這個時間段是否會稍微延長？謝謝。

With respect to rates, your the model that you've articulated is exactly the right model, which is why we are strongly advocating using a baseline period of July '24 to July '25 because that will capture a lot of the cost inflection that's already occurred. Trending off the most recent baseline that includes the inflection is the best position to be in, and we're hoping states in recognizing that there's been a cost inflection, we'll use that as the baseline period.

關於利率，您所闡述的模型完全正確，這就是為什麼我們強烈主張使用 2024 年 7 月至 2025 年 7 月作為基準期，因為這將捕捉到已經發生的大量成本變化。從包含拐點的最新基線趨勢來看，這是最好的情況，我們希望各州認識到已經出現了成本拐點，我們將以此作為基線期。

Then, of course, as you suggested, is, okay, what's the most recent trend? And are you putting enough trend into the rates. Trend is typically 2%, 3%, maybe 4% in a bad year in Medicaid. We're forecasting 6% this year year-over-year, 1.6% per quarter. So, you're asking the right question.

那麼，當然，正如您所說，最近的趨勢是什麼？您是否將足夠的趨勢納入利率中？在醫療補助計畫不景氣的年份，趨勢通常是 2%、3%，甚至 4%。我們預測今年的年成長率為 6%，每季的成長率為 1.6%。所以，你問的是正確的問題。

Will one by one on catch up a bit completely. We're at 90 call it, 91% MCR, 200 basis points, 190 basis points above the top end of our range. So we need 200 basis points on top of trend in order to get back to our target margin.

就逐一的追上一點兒了。我們的呼叫率為 90%，MCR 為 91%，為 200 個基點，比我們範圍的上限高出 190 個基點。因此，我們需要在趨勢基礎上再增加 200 個基點，才能回到我們的目標利潤率。

We think the broader market based on external analysis needs a lot more than that. So if we can get 200 basis points on top of an appropriate trend, it will bring us back into target margin territory, whether that happens on one by one '26 or not remains to be seen. Mark, anything to add?

我們認為基於外部分析的更廣泛的市場需要的遠不止這些。因此，如果我們能夠在適當的趨勢之上獲得 200 個基點，它將使我們回到目標利潤率領域，但這是否會在 26 年逐一實現還有待觀察。馬克，還有什麼要補充的嗎？

Kevin, on the embedded earnings question, yes, $865 million, unchanged. $865 million our embedded earnings is always an ultimate run rate that we talked about and the reason that in the near term, it can be something less than the ultimate has historically been because we buy fixer uppers, and it takes us a year or two to get them to target margin. In a situation like where we are right now, another reason that initial earnings is different than Ultimate is obviously just where we are on industry trends and rates.

凱文，關於內含收益的問題，是的，8.65 億美元，沒有變化。 8.65 億美元的內含收益始終是我們談論的最終運行率，而短期內它可能低於最終運行率的原因歷來是因為我們購買的是需要修繕的房屋，我們需要一兩年的時間才能使它們達到目標利潤率。在我們目前的情況下，初始收益與最終收益不同的另一個原因顯然是我們所處的行業趨勢和利率。

So I don't think $865 million changes because in the long term, these markets need to be appropriately funded we'll have to wait till guidance for 2026 to let you know specifically how that affects what we realize next year out of the $865 million, but the principle stays the same and the ultimate is intact.

因此，我認為 8.65 億美元不會發生變化，因為從長遠來看，這些市場需要適當的資金，我們必須等到 2026 年的指導才能讓您具體知道這將如何影響我們明年從 8.65 億美元中實現的收益，但原則保持不變，最終目標保持不變。

Ryan Langston from TD Cowen.

TD Cowen 的 Ryan Langston。

Good morning. On the exchange side, I believe in the past, you've given us some commentary on what I might call a same-store basis. Is there any way you can call out unit utilization for your same membership that you had in 2024? And this year versus the new members in 2025 and maybe just any differences between those two cohorts?

早安.在交易方面，我相信過去您已經就我所謂的同店基礎給了我們一些評論。有什麼方法可以查詢您在 2024 年擁有的相同會員資格的單位利用率嗎？那麼今年與 2025 年的新成員相比，這兩個群體之間可能存在什麼差異？

I'll kick it to Mark. Well, I'll frame it for you. Interestingly enough, this year, whether a member came in through OEP or SEP or whether they're we call it the freshman class or the sophomore class, everything land higher than expected. In sometimes and usually, there is a disparity SEP members given the free period of getting in when you need it, usually run hotter as the initial year and then settle down, but this year, whether a member came in through OEP, SEP or whether they're the freshman class or the sophomore class or beyond, we saw very little distinction in the performance of the member. .

我會把它踢給馬克。好吧，我會把它裱框起來給你。有趣的是，今年，無論是透過 OEP 還是 SEP 加入的成員，也無論他們被稱為新生還是二年級學生，一切成績都高於預期。有時，通常情況下，SEP 成員在需要時會給予自由加入期，通常在第一年表現會更出色，然後穩定下來，但今年，無論成員是透過 OEP、SEP 加入，還是他們是新生班、二年級或更高年級加入，我們都很少看到成員的表現有差別。。

We do have a lot of members that have very low HCCs, which means you're not going to get risk adjustment, but that is typical for this line of business. Mark, anything to add.

我們確實有很多會員的 HCC 非常低，這意味著您不會獲得風險調整，但這對於該行業來說很常見。馬克，還有什麼要補充的嗎？

Look, I think that's well summarized. It's just 1 more data point that high trend by utilization is pervasive from so many perspectives.

看，我認為這總結得很好。從許多角度來看，利用率高趨勢普遍存在，這只是另一個數據點。

Got it. And then just last thing. I know on the long-term side, I know you say you're pretty confident there, but if the 1 BBB is going to impact Medicaid for probably a few years in the HICS market just constantly shifting I guess does that imply you have to rely more on some of this accretive M&A to hit those longer-term goals? thanks

知道了。接下來是最後一件事。我知道從長遠來看，我知道您說您對此非常有信心，但如果 1 BBB 將在 HICS 市場中對醫療補助產生持續幾年的影響，我想這是否意味著您必須更多地依賴一些增值性併購來實現這些長期目標？謝謝

Well, I think on the hits, you've captured it appropriately. We like it at 10% of revenue. Small silver stable because every time you're lulled into thinking the risk pool hasn't shifted yet another government regulation or competitive force that causes it to shift. So we like it where it is. Mark, anything to add on that?

嗯，我認為從點擊量來看，你已經恰當地捕捉到了它。我們喜歡將其設為收入的 10%。小銀價之所以穩定，是因為每次你都被哄騙去認為風險池沒有發生變化，而另一項政府法規或競爭力量又會導致風險池發生變化。所以我們喜歡它現在的樣子。馬克，還有什麼要補充的嗎？

No, I think that's appropriately said. Over time, if we can keep it small, silver and stable, it will be a nice kicker and minimal exposure in down markets. even this year where marketplace is not just an attractive place, we're still going to make very small, low single-digit pretax margins.

不，我認為這是恰當的說法。隨著時間的推移，如果我們能夠保持其規模小、品質高且穩定，那麼在低迷的市場中，它將會是一個很好的激勵因素，並且風險敞口最小。即使今年市場不再具有吸引力，我們仍然會獲得非常小的、低個位數的稅前利潤率。

Sarah James from Cantor Fitzgerald.

來自 Cantor Fitzgerald 的 Sarah James。

Thank you. I wanted to go back to a comment on sometimes taking a few years to bring M&A in line. When you think about ConnecticutCare, is that something that you think could run at margins similar to the rest of your book in '26? Or could that take until '27 and then just given the growth in exchanges this year, can you touch on if you still think you're going to end year-end at 620 members? And what the increase meant to MLR pressure this quarter?

謝謝。我想回顧一下有時需要幾年時間才能完成併購的評論。當您考慮康乃狄克州健保 (ConnecticutCare) 時，您是否認為它的利潤率能與您 1926 年書中的其他內容相似？或者這可能需要等到 27 年，然後考慮到今年交易所的成長，您是否仍認為年底會員數會達到 620 名？那麼此次上調對本季MLF壓力意味著什麼？

Thanks. Sarah, if I recall correctly, the Connecticure acquisition model had us getting to target margins in a two year period confirm a year. That was the original assumption. There's two competitors in the market. We're one of two. Obviously, we'll have to put rates in the market to get us there, but that was a two year scenario of 2027 to get back to target your second question.

謝謝。莎拉，如果我沒記錯的話，康乃狄克州的收購模式讓我們在兩年內就達到了目標利潤率。這是最初的假設。市場上有兩個競爭對手。我們就是其中之一。顯然，我們必須將利率投入市場才能實現這一目標，但這是 2027 年的兩年情景，以回到您的第二個問題。

On your second question, Sarah, was on Marketplace membership. We're seeing just a little bit more on SAP, not dramatically big, but I'm expecting about 650 of membership by year-end. So just a little bit more than we thought before.

莎拉，你的第二個問題是關於市場會員資格的。我們看到 SAP 的會員數量略有增加，雖然不是特別多，但我預計到年底會員數將達到 650 人左右。所以比我們之前想像的要多一點點。

And did that contribute to some of the pressure in the quarter, the growth in and, I guess, now the higher membership at year-end?

這是否加劇了本季的壓力、成長，以及年底會員人數的增加？

Well, it's a little bit more for a couple of reasons. SEP is the big one. And as we said, they're not coming in, in a meaningfully different place as far as we know from the rest of the book. In the past years, sometimes SEP came in for all the wrong reasons, right, because of the changes in SEP rules this year, it feels like they're coming in not as immediate pent-up demand, but pretty much with the same acuity and utilization profiles as the rest of the book.

嗯，由於幾個原因，它有點多。SEP 是最重要的。正如我們所說的，就我們從本書的其餘部分所知，他們並沒有進入一個有意義的不同的地方。在過去的幾年裡，有時 SEP 的出現都是出於錯誤的原因，對吧，因為今年 SEP 規則的變化，感覺它們的出現並不是因為立即被壓抑的需求，而是與書中的其餘部分具有相同的敏銳度和利用率。

So I don't know that I would attribute necessarily more MLR pressure to what is a subtle increase in membership.

因此，我不知道我是否應該將更多的 MLR 壓力歸因於會員人數的微妙增長。

John Stansell from JPMorgan.

摩根大通的 John Stansell。

Great. Just want to circle back to the M&A pipeline. Clearly, in the prepared remarks, you highlighted that the pipeline is active and that there are smaller players, who are probably struggling with some of these pressures more than you are how do you balance that with other capital deployment options around things like share repo right now and think about that framework for the next 6 to 18 months?

偉大的。只是想回到併購通路。顯然，在準備好的發言中，您強調了管道是活躍的，並且有一些規模較小的參與者，他們可能比您更難以應對這些壓力，您如何平衡這些壓力與其他資本部署選項，例如當前的股票回購，並考慮未來 6 到 18 個月的框架？

Well, obviously, we'll be opportunistic with share repurchases. It's always part of our capital plan, but it's the third use of capital. Organic growth is number 1 because of the operating leverage is huge. Second is M&A. We're buying these things barely above book value, and they are fixer uppers, but we know how to get these things to target margins.

嗯，顯然，我們會抓住機會回購股票。它始終是我們資本計劃的一部分，但它是資本的第三種用途。由於經營槓桿巨大，有機成長位居第一位。第二是併購。我們購買這些東西的價格略高於帳面價值，而且它們都是需要修繕的房屋，但我們知道如何讓這些東西達到目標利潤率。

And more of them are in the market today than even three to six months ago, single geography players don't have the diversification benefit that we have and others have. If you don't if you're a single geography player and you've got a rate problem, you got a problem.

與三到六個月前相比，如今市場上的公司數量更多，單一地區的公司不具備我們和其他人所擁有的多元化優勢。如果您不這樣做，如果您是單一地理玩家，並且您遇到了速率問題，那麼您就會遇到問題。

So we're seeing more of these come to market, in a very subtle way. So we're opportunistic and optimistic that we'll harvest some M&A here, the same way we always have and maybe even at better rate than 25% of revenue purchased. Mark, anything to add?

因此，我們看到越來越多的此類產品以非常微妙的方式進入市場。因此，我們抓住機會並樂觀地認為，我們將在這裡收穫一些併購，就像我們一直以來那樣，甚至可能以比購買 25% 的收入更好的比率。馬克，還有什麼要補充的嗎？

The only thing I'd add is I think about dry powder and capital all the time, as you would expect. And if you just look at our balance sheet, our cash flow, projecting anything forward. I'm comfortable someplace between $1.5 billion and $2 billion is what our dry powder is over the coming year, which puts us well positioned for a variety of ways to deploy it. We always prefer organic growth, but M&A is going to be a big part of it going forward, and we always have an eye towards share repurchase.

我唯一要補充的是，正如您所期望的，我一直在考慮乾火藥和資本。如果你看一下我們的資產負債表、現金流，就能預測未來的一切。我確信，未來一年我們的現金儲備將在 15 億美元至 20 億美元之間，這使我們能夠以各種方式部署這些現金。我們始終傾向於有機成長，但併購將成為未來成長的重要組成部分，我們始終關注股票回購。

If we did take advantage and of the market where it is now and did a share repurchase, it would not impact our ability to do M&A at the amount of revenue we need to acquire and at the price that we acquire.

如果我們確實利用當前的市場並進行股票回購，那麼它不會影響我們以我們需要獲得的收入金額和收購價格進行併購的能力。

Great. And if I can just squeeze one more in. At Investor Day last year, you did highlight the idea that marketplace might have a pull forward of demand in the fourth quarter ahead of subsidy expiration or integrity rule changes, is that embedded in the current guidance that there will be uptick beyond normal seasonality in the fourth quarter for your marketplace business?

偉大的。如果我能再擠進一個的話。在去年的投資者日上，您確實強調了在補貼到期或誠信規則變化之前，市場需求可能會在第四季度提前，這是否包含在當前的指導中，即第四季度您的市場業務將出現超出正常季節性的增長？

Absolutely. With marketplace, I think you have to be very conservative on your projections. There's a few things in the back half of the year. Some people refer to what you're talking to about is induced demand at the end of the year, fourth quarter, maybe, I mean it's a valid concept. Just historically, in these situations, we don't see it.

絕對地。對於市場，我認為你必須對你的預測非常保守。下半年有幾件事。有些人提到您所說的是在年底或第四季度誘導需求，也許，我的意思是這是一個有效的概念。從歷史上看，在這種情況下，我們並沒有看到這種情況。

There's FTR, which we really haven't talked about. I don't think it's a meaningful item for us in the third quarter. But of course, we have placeholders and our projections for these kind of items. I just don't think either of them are particularly meaningful.

還有 FTR，我們其實還沒有談論過。我認為這對我們來說在第三季不是一個有意義的項目。但當然，我們對這些類型的項目有佔位符和預測。我只是認為它們都沒有什麼特別的意義。

With a trend increase from 7% in our original guidance to 11% we think we have it captured.

隨著趨勢從我們最初指導的 7% 增長到 11%，我們認為我們已經掌握了它。

Erin Wright from Morgan Stanley.

摩根士丹利的 Erin Wright。

Great thanks. So you gave us some of your expectation on the impact of the 1 big beautiful bill on the expansion population. But how do you think about that cadence of that? And what are you factoring now in terms of state mitigation efforts? Or does this not incorporate that at this point and that would be upside?

非常感謝。所以您給了我們一些關於《1大美麗法案》對擴張人口的影響的預期。但是您如何看待這種節奏呢？那麼，就國家緩解措施而言，您現在考慮的因素有哪些？或者這目前還沒有體現出來，而且這還是一個優點？

All of our membership projections at this point the $46 billion for 2026 and $52 billion for 2027 do not yet include an estimate from the budget bill. We are working on it. Regulations have not come out yet on exactly how it's going to work. There is flexibility on the timing of the state to implement the biannual reverification and the work requirements. So which states will take advantage of that.

目前，我們所有會員的預測（2026 年為 460 億美元，2027 年為 520 億美元）尚未包括預算法案中的估計。我們正在努力。目前尚未出台關於其具體如何運作的規定。各州對於實施一年兩次的重新核查的時間和工作要求具有彈性。那麼哪些州將利用這一點呢？

We'll follow political lines, red blue. We just don't know yet.

我們將遵循政治路線，紅藍。我們只是還不知道。

But we do believe that what will happen will be gradual and not abrupt and therefore, allow the market, not only the market to adjust to it from an acuity perspective, but the administrative burden on the space to actually do this is going to be significant and it will be in their best interest to do it gradually and not abrupt.

但我們確實相信，接下來發生的事情將是漸進的，而不是突然的，因此，不僅允許市場從敏銳的角度進行調整，而且實際做到這一點的空間行政負擔將是巨大的，逐步而不是突然地做到這一點符合他們的最佳利益。

Our revenue does not our revenue estimates at $46 billion and $52 billion do not yet include an estimate from the budget bill.

我們的收入預計為 460 億美元和 520 億美元，其中還不包括預算法案中的估計數。

Great, thank you.

太好了，謝謝。

Michael Halloran from Baird.

來自貝爾德的邁克爾·哈洛倫。

Thank you. So when I look at your updated guidance, I know you embedded a wide range of outcomes in your MLR and you talked about added conservatism. But when I look at the implied second half MLR progression versus your historical average first half versus second half seasonality for both total MLR and by segment.

謝謝。因此，當我查看您更新的指南時，我知道您在 MLR 中嵌入了廣泛的結果，並且談到了增加保守性。但是，當我查看隱含的下半年 MLR 進展與歷史平均上半年和下半年總體 MLR 和細分市場的季節性變化時。

Does it appear to be overly overly conservative versus historical Scott, Mark, I know you mentioned the list of things FTR rechecks, induced utilization, maybe even more SEP member picked up and redetermination pressure. But of those list of items you've mentioned wanted to get a sense of which 1 right now, do you think carries the most, call it, uncertainty and potential magnitude of impact into the remainder of the year?

與歷史相比，這是否顯得過於保守了？史考特、馬克，我知道您提到了 FTR 重新檢查、誘導利用、甚至更多 SEP 成員拾取和重新確定壓力等事項的清單。但是，在您提到的這些事項清單中，您想了解目前哪一項事項最具不確定性，並且對今年剩餘時間產生最大影響？

I'll frame it and kick it to Mark. But our first half marketplace MCR with 837 on a reported basis. As Mark said, it includes 200 to 300 basis points of nonrecurring items, both the ConnectiCare, acquisition drag and some of those onetime items from the first quarter. So call it, 81%, 82% and it's progressing to 86.6% in the second half to blend to the 85% for the full year. So there is a pretty meaningful normalized increase first half to second half.

我會把它裱起來並踢給馬克。但據報告，我們上半年的市場 MCR 為 837。正如馬克所說，它包括 200 到 300 個基點的非經常性項目，包括 ConnectiCare、收購拖累以及第一季的一些一次性項目。所以我們稱之為 81%、82%，下半年將成長至 86.6%，全年將達到 85%。因此，上半年到下半年的正常化成長相當有意義。

That's exactly right. If you go through the normalized numbers, I hit in the script, normalized 80% in the first half goes to a normalized 86% in the second half. That's beyond normal seasonality. We all know that marketplace is seasonal because of co-pays, deductibles and things like that in the first half. But that 600 basis point shift first half to second half is beyond what we would normally see in our mix of metallics.

完全正確。如果您查看標準化數字，我在腳本中輸入，上半年標準化為 80%，下半年標準化為 86%。這超出了正常的季節性。我們都知道，由於上半年有共同支付、免賠額等因素，市場有季節性。但上半年到下半年的 600 個基點的轉變超出了我們在金屬組合中通常看到的水平。

So I think there's a lot of conservatism baked in there. And the same means we have first half, second half in Medicare, 89.2% going to a 99.9% in the second half. That's a pretty meaningful shift beyond what you would normally see.

所以我認為這裡蘊含著許多保守主義思想。同樣的，這意味著我們的醫療保險有上半年和下半年，前半年的比例為 89.2%，後半年的比例將達到 99.9%。這是一個非常有意義的轉變，超出了你通常所見的範圍。

And then Medicaid, we've got just a little bit hotter in the second half, but that's with a very big assumption on trend, which, as Joe said, it just continues as much as it was first and second half. and a pretty good rate pattern that we thought was enough to really give us a kick in the second half, which is now going to just keep us level. So I think we've got a fair amount of conservatism layered in here, which is why we feel pretty good about saying $19 as a 4.

然後是醫療補助，我們在下半年會稍微熱一些，但這是基於對趨勢的一個非常大的假設，正如喬所說，它會像上半年和下半年一樣繼續下去。而且我們認為一個相當不錯的利率模式足以在下半年為我們帶來推動，現在這將使我們保持水平。所以我認為我們在這裡有相當多的保守主義，這就是為什麼我們覺得 19 美元作為 4 是相當不錯的。

Thank you. And just another question. So longer-term topics of policy I understand you're expecting 15% to 20% ultimate impact on your expansion population. I know you mentioned this a few times, already. But I guess just given what we saw with the last redetermination, I guess the magnitude of unexpected outsized refutal disenrollment. And as it relates to work requirements to the extent that does drive more outsized procedural this enrollment for even members that might that maybe you shouldn't even be eligible for work requirements that pressure is rate versus security.

謝謝。還有一個問題。因此，我了解到，長期政策主題預計最終將對擴張人口產生 15% 到 20% 的影響。我知道您已經提到過幾次了。但我想，根據我們在上次重新確定中看到的情況，我想意外的超大規模的拒絕取消入學人數的規模是可以想像的。並且，由於它與工作要求有關，這確實會推動更加龐大的程序，即使是成員也可能認為你甚至不應該有資格滿足工作要求，而壓力在於速度與安全性。

Just trying to think, are there any learnings from your recent redetermination, things that Molina can do to potentially practically perhaps engage your own Medicaid patient promote compliance, help prevent procedural disenrollment going forward? Thank you.

只是想一想，您從最近的重新決定中得到了什麼教訓，莫利納可以做些什麼來實際地讓您自己的醫療補助患者參與進來，促進依從性，幫助防止將來出現程序性取消註冊？謝謝。

We are working state by state to make sure that the administrative process goes smoothly and everything we can do to help. Now to your question, the data as we analyze the $1.3 million expansion members that we have, there is a definition of able-bodied. I don't like the term, but that's the term that it's used.

我們正在逐州開展工作，以確保行政流程順利進行，並盡我們所能提供協助。現在回答你的問題，當我們分析擁有的 130 萬美元擴展成員的數據時，對健全有一個定義。我不喜歡這個術語，但這就是它的用法。

And people with certain medical conditions are not able body a significant number of our expansion members meet that definition and therefore, qualify for 1 of the exclusions and could stay on. Of the remaining two by three of the remaining our data shows work in some capacity. Now they may not be working to the capacity of 80 hours a month, we don't know, but they are working in some capacity. And by the way, at a minimum job at a minimum wage job for 80 hours a month, you still might be under 100% of FDL.

患有某些疾病的人無法身體健康，我們相當一部分擴展成員符合這一定義，因此有資格獲得其中一項排除條款並可以繼續留在原地。在剩下的兩個和剩下的三個中，我們的數據顯示它們在某種程度上發揮了作用。現在他們可能沒有達到每月 80 小時的工作能力，我們不知道，但他們正在做一些工作。順便說一句，即使每月工作 80 小時，領取最低工資，您的收入仍可能低於 FDL 的 100%。

So we're analyzing the book of business. That's all we can do right now. And it's too complicated to go in and how we're working with our state-based partners on a gradual approach to doing this in a meaningful way and what we can do to help. But that's our best estimate for now. It's consistent with the think tank estimates and the consulting house estimates and if it happens gradually over time, the market can absorb it.

所以我們正在分析商業帳簿。這就是我們現在所能做的一切。這太複雜了，我們如何與州級合作夥伴一起逐步、有意義地完成這項工作，以及我們可以提供什麼幫助。但這是我們目前最好的估計。這與智庫和諮詢機構的估計一致，如果它隨著時間的推移逐漸發生，市場可以吸收它。

Jason Cassorla from Guggenheim.

古根漢美術館的 Jason Cassorla。

Great. I just wanted to ask about the embedded earnings number. You left at the same at $865 million. I know you got the dollar implementation costs that don't wind next year. But maybe can you just give us a sense of how much of that embedded earnings you can kind of like feasibly harvest next year or how to think about that just as we think about next year?

偉大的。我只是想問一下嵌入式收益數字。您離開時的薪水仍為 8.65 億美元。我知道您已經獲得了明年不會結束的美元實施成本。但是，您能否讓我們了解明年您可以實際收穫多少內含收益，或者我們如何看待明年的內含收益？

Yeah, I'm not going to give you specific numbers, and you'll appreciate why, but some framing concepts. So the $865 is comprised of about $2.25 from acquisitions. and about $5.40 from new contract wins. You add in 1 of the implementation cost that's in our P&L this year that just automatically reverse next year.

是的，我不會給你一個具體的數字，你會明白為什麼，但會給出一些框架概念。因此，865 美元中約有 2.25 美元來自收購，約有 5.40 美元來自新合約的簽訂。您加入今年損益表中的 1 項實施成本，明年就會自動沖銷。

those are the components that get you to $8.65. Now the good news, and Joe pointed this out, is the dollar has no execution risk. It just happens. We're not going to spend that money next year.

這些因素共同作用，最終將美元匯率推高至8.65美元。好消息是，正如喬指出的那樣，美元沒有執行風險。它就這樣發生了。明年我們不會花這筆錢。

Now of the remaining, we have a really good transformation and integration team that look at our acquisitions and also look at our new implementations. They're doing a good job tracking from an operating perspective to the ultimates. The wildcard then becomes where are we in the rate cycle and what would have been a 4.5% pretax margin at the ultimate does it take longer to get there because of the rate cycle.

現在，我們擁有一支非常優秀的轉型和整合團隊，他們負責審查我們的收購，也負責審查我們的新實施。他們在從營運角度到最終目標的追蹤方面做得很好。那麼，不確定因素就變成了我們處於利率週期的哪個階段，以及最終的 4.5% 稅前利潤率是否會因為利率週期而需要更長時間才能達到這一目標。

Well, Joe and I don't have a view on the rate cycle for January 1, yes, so I just can't give you a view on that. Rate cycle aside, we feel pretty good about what I've said in the last couple of quarters, which is roughly one by three of that $865 would come out next year.

嗯，喬和我對 1 月 1 日的利率週期沒有看法，是的，所以我無法給你這方面的看法。撇開利率週期不談，我們對過去幾季我所說的情況感覺相當樂觀，即明年大約會有三分之一的 865 美元的利率到位。

Okay. Got it. And maybe if I could just follow-up. I wanted to go back to your commentary on Medicaid inpatient outpatient specifically. I know you spiked kind of calling those out was that kind of were those pieces kind of included in previous commentary around trend.

好的。知道了。也許我可以跟進一下。我想特別回顧一下您對醫療補助住院門診的評論。我知道您尖銳地指出了這些內容，這些內容是先前關於趨勢的評論中包含的內容。

Or are you seeing that those two kinds of accelerate at this juncture? And then thinking about the inpatient outpatient that you're seeing, like should we think about that as the new cost baseline for which to grow off of for those pieces or the inpatient outpatient you're just seeing kind of like a spike in the near term? Just any color around the inpatient and outpatient side would be helpful.

或者說，您認為這兩種情況在這個節點上會加速成長嗎？然後，想想您所看到的住院門診情況，我們是否應該將其視為新的成本基準，並以此為基礎來成長這些部分？或者說，您看到的住院門診情況在短期內會呈現高峰增長？住院部和門診部周圍的任何顏色都會有幫助。

Yes. As we started to talk about trend as early as the third quarter of 2024 in Medicaid, we mostly attributed it to high-cost drugs, LTSS services, both skilled nursing and home-based services and behavioral. That persisted into the fourth quarter. I will say that the inpatient outpatient what we call core utilization did start to trend in the first quarter of this year, but the increase in the second quarter was significant that it deserved to call out.

是的。當我們早在 2024 年第三季就開始談論醫療補助的趨勢時，我們主要將其歸因於高成本藥物、LTSS 服務、熟練護理和家庭服務以及行為。這種情況一直持續到第四季。我想說的是，住院門診（我們所說的核心利用率）在今年第一季確實開始呈現趨勢，但第二季的成長非常顯著，值得關注。

And I believe it's consistent with what everybody else is saying, what the national provider reports are saying ER visits up significantly. What happens when somebody goes through the ER, they get admitted. And they're being admitted for complex medical conditions, not for episodic care or for episodic care, but for complex conditions.

我相信這與其他所有人的說法一致，國家提供者的報告顯示急診室就診人數大幅增加。當有人經過急診室時會發生什麼事？他們被接納了。他們入院是因為病情複雜，不是為了偶爾接受護理或偶爾接受護理，而是為了治療複雜的疾病。

On the outpatient side, people are going to get their screenings and seeing their primary care physicians. Is it back to prepandemic levels likely and once you go to see your PCP or get a screening, there is typically a specialist follow-up visit. So yes, the trend on those two categories, in particular, began to trend up in the first quarter, but the rate cycle kept pace of it. But it spiked yet again in the second, and we decided to call it out.

在門診方面，人們將接受篩檢並看初級保健醫生。是否有可能恢復到疫情前的水準？一旦你去看你的初級保健醫生 (PCP) 或進行篩檢，通常都會有專科醫生的追蹤。是的，這兩個類別的趨勢在第一季開始呈現上升趨勢，但利率週期也隨之維持上升趨勢。但在第二場比賽中，它再次飆升，我們決定將其叫出。

George Hill from Deutsche Bank

德意志銀行的喬治·希爾

Yeah, good morning, guys. Thanks for taking the question.Yes. I have two, first, Mark, at a high level, you'll get the free book next year from the implementation costs and the embedded earnings this should help grow earnings in '26. But I guess from where you sit right now, is it clear that you guys can grow underlying earnings in 2026?

是的，大家早安。感謝您回答這個問題。是的。我有兩個問題。首先，馬克，從高層角度來說，明年您將從實施成本和內含收益中獲得一本免費的書，這應該有助於26年的收益成長。但我想從您現在所處的位置來看，你們是否清楚能夠在 2026 年實現基本盈利的增長？

And then Joe, my follow-up would just be given what you guys saw in the redetermination process as we move in the future to a biannual redetermination process, I would just hold your commentary on like beneficiary response rates and time to turn to get people reenrolled and kind of like kind of following up on Michael's question, how disruptive do we expect that to be?

然後喬，我的後續問題是，鑑於你們在重新確定過程中看到的情況，隨著我們未來轉向每兩年一次的重新確定過程，我只想保留你對受益人回复率和讓人們重新登記的時間的評論，有點像跟進邁克爾的問題，我們預計這會造成多大的破壞？

I'll answer the second question first. On the biannual redetermination process. I mean it's really a question of math. If somebody became ineligible during a year, didn't notify the state, it's possible that we're collecting premium for 11 months. without anybody legitimately collecting premium for 11 months until they had to reverify and couldn't now the maximum that somebody can go unverified is five or six months.

我先回答第二個問題。關於每兩年一次的重新確定過程。我的意思是這確實是個數學問題。如果某人在一年內失去資格，且未通知州政府，則我們可能需要收取 11 個月的保費。如果沒有任何人合法地收取 11 個月的保費，直到他們必須重新驗證，而現在無法重新驗證，那麼某人未經驗證的最長時間是五六個月。

So there will be a slight decline in membership as a result of that faster spend, that faster churn, but it's all contemplated in the model. On your first question about underlying earnings, it's too early for 2026. The building blocks are the rate cycle for Medicaid, our rate filings for marketplace and embedded earnings. And it's just too early to put the pieces together.

因此，由於支出加快、流失加快，會員數量會略有下降，但這一切都已在模型中考慮到。關於你關於基本收益的第一個問題，現在預測 2026 年還為時過早。其基本組成部分是醫療補助的費率週期、我們的市場費率申報和嵌入式收益。現在把這些碎片拼湊起來還為時過早。

But as we move forward here to Q3 and perhaps even Q4, we give guidance for next year, we'll give as we always have, we'll give the building blocks of what our 2026 outlook is. Medicaid rate cycle one by one, Key, our marketplace rate filings, second key and third, maybe up to one by three of the 865 and better earnings. But that's as much as I can say right now at this early stage.

但隨著我們進入第三季甚至第四季度，我們將為明年提供指導，我們將像往常一樣，提供 2026 年展望的基礎。醫療補助費率週期逐一，關鍵，我們的市場費率備案，第二個關鍵和第三個，可能高達 865 的三分之一和更好的收入。但目前在早期階段我只能說這麼多。

This concludes our question-and-answer session. I would like to turn the conference back over to the speakers for any closing remarks.

我們的問答環節到此結束。我想將會議交還給發言者，請他們作結束語。

Thank you very much for your time this morning. We'll be available for any follow-up questions. Thank you, and have a great day.

非常感謝您今天上午抽出時間。我們將解答任何後續問題。謝謝您，祝您有愉快的一天。

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

會議現已結束。感謝您參加今天的演講。您現在可以斷開連線。