Oscar Health, Inc. (OSCR)

Oscar Health reported second-quarter 2026 revenue of $4.9 billion, up from $2.9 billion a year earlier, and net income of $361.8 million 3.

Medical costs took a smaller share of premiums, so the medical loss ratio (medical costs as a percent of premiums) was 79.2 percent against 91.1 percent a year earlier 3. The company credits its pricing and $164 million of favorable development on earlier medical claims 3.

About 3.0 million people were enrolled in its plans on 30 June 2026, around 46 percent more than a year before 2.

On 16 September 2026 the company raised its 2026 outlook and now expects earnings from operations of $600 million to $800 million 4.

The open question is how many people stay insured, since the company says subsidies that expired at the end of 2025 cut marketplace participation and its own membership after the 2026 enrollment period 2.

Oscar was founded in 2012 and calls itself a healthcare technology company built around its own software platform 1.

Its core business is health plans for individuals and families under the Affordable Care Act (ACA), the federal law that set up the health insurance marketplaces 1.

A co-branded small group plan with Cigna was not renewed after its first term ended on 31 December 2024 1.

In 2024 revenue was $9.18 billion and the company made a small profit of $25.4 million 1.

In 2025 premium revenue rose 28 percent, driven by more members from a strong open enrollment 1. Total revenue reached $11.70 billion 1.

The profit turned into a net loss of $443.2 million in 2025 1. The medical loss ratio climbed from 81.7 percent to 87.4 percent 1.

Selling and administrative costs rose 17 percent in 2025, mostly from broker commissions and taxes that grow with membership 1.

In the first half of 2026 revenue rose 62 percent to $9.5 billion, as membership and rates grew 2.

The company points to sicker people across the market and higher use of care that federal risk adjustment did not fully offset 1. Risk adjustment is a federal program that moves money between insurers to even out differences in how sick their members are 2.

For funding, the company issued $410.0 million of convertible notes (loans that can turn into shares) due 2030 in September 2025 1.

In November 2025 the investor Dragoneer exchanged $187.5 million of older 2031 notes for about 22.5 million Class A shares 1.

Individual health plans

Oscar offers plans in the individual market in the five ACA metal categories: Catastrophic, Bronze, Silver, Gold and Platinum, which differ in monthly premium and in how costs are shared with the member 1.

It covered people in 18 states for the 2025 policy year and expanded to 20 states for 2026 1.

Florida is the biggest market, with 1,179,934 of its 2,042,449 members on 31 December 2025, and Texas is next with 358,910 1.

In 2025, 93 percent of premiums came directly from CMS, the federal Medicare and Medicaid agency, as subsidies, and 7 percent came from members 1.

In the first half of 2026 the medical loss ratio was 75.0 percent and earnings from operations were $1.09 billion 3.

Technology and brokerage businesses

The +Oscar platform lends the company's technology to others, and its Campaign Builder tool helps insurers and providers decide whom to contact and how, with nearly 0.6 million client lives at the end of 2025 1.

In 2025 it acquired an enrollment platform (Lucie), an individual-market brokerage (IHC Specialty Benefits) and a consumer education site (Healthinsurance.org) to support employer-funded plans 1.

An ICHRA lets an employer give workers a fixed sum to pay for an individual plan of their own 1.

People and workforce

Mark Bertolini is chief executive 3. Co-founder Mario Schlosser moved from chief technology officer to adviser to the chief executive on 1 June 2026 and stays on the board 5.

The company had about 2,305 employees on 31 December 2025 1.

Rivals and current problems

The company names national carriers, regional carriers, Medicaid-focused insurers and local Blue Cross plans as its main rivals in the individual market 1.

A federal court in Maryland nullified parts of CMS's 2025 enrollment-verification rules on 12 June 2026 and on 16 July 2026 paused parts of the 2027 payment notice, in lawsuits brought by cities 2.

The umbrella, in words

The company wholly owns three marketplace businesses: Lucie, Trove Group (formerly IHC Specialty Benefits) and HealthInsurance.org 2.

Its health insurance and HMO subsidiaries held cash and investments of $9.7 billion on 30 June 2026 2.

It leases its New York headquarters and six other offices in the U.S. 1.

Control sits with Class B stock, which carries 20 votes a share against one for Class A 1. At 31 December 2025 Class B holders, Thrive Capital and the co-founders, owned 16.6 percent of the capital stock and held 76.1 percent of the votes 1.

Thrive Capital and Joshua Kushner, as sole managing member of Thrive's general partners, beneficially owned 14.5 percent of the stock and 67.9 percent of the votes 1.

For 2026 the company expects a medical loss ratio of 81.0 to 82.0 percent and earnings from operations of $600 million to $800 million, both improved on 16 September 2026 4.

It reaffirmed total revenue of $18.7 billion to $19.0 billion and a selling and administrative expense ratio of 15.6 to 16.1 percent 4.

The company says a court pause means many older enrollment rules stay in place for the 2027 open enrollment, which reverts to 1 November to 15 January, unless the court lifts it 2.

If the paused provisions are put in force, it expects them to affect subsidy eligibility and enrollment from the 2027 open enrollment 2.

The company says 100 percent tariffs on patented drugs, proclaimed on 2 April 2026, could cut the rebates it receives and raise its medical loss ratio 2.

Its stated goal is to be the preferred carrier for employees who enroll through an ICHRA program 1. Class B stock converts to Class A automatically on 2 March 2028 unless converted earlier 1.