Molina is a government-funded managed-care company. It doesn't sell insurance to the public — it wins contracts from state Medicaid agencies and the federal government to run health plans for low-income and dual-eligible people. It collects a fixed monthly premium per member (~$40B/yr across ~5.9M members) and profits only on the thin gap between that premium and the medical claims it pays — its medical care ratio runs near 90%, so a point of cost is the whole margin.
A toll-booth on government health spending
Molina sits between the government and the doctor. States and the federal government hand it a fixed monthly cheque for each enrolled person; Molina builds a network of hospitals and physicians and pays their bills. Its profit is only the sliver between the premium in and the claims out — so managing medical cost, not selling more, is the whole game.