Oscar Health Reports Another Big Profit As Obamacare Member Costs Ease

Oscar Health, a major player in individual health coverage under the Affordable Care Act, achieved a $361 million profit in the second quarter and exceeded $1 billion in net income for the year’s first half, driven by membership growth and lower medical expenses.

Oscar’s membership expanded to 2.9 million from just over 2 million a year prior, propelling a 70% increase in quarterly revenue to $4.9 billion.

Since its founding in 2012, Oscar had faced challenges in consistently posting quarterly profits. However, under the leadership of Mark Bertolini, appointed as CEO in March 2023, the company has successfully turned the tide, demonstrating confidence in the individual health insurance market.

Oscar’s success in expanding Obamacare offerings and managing costs coincides with competitors withdrawing from the individual market. Aetna, part of CVS Health, exited this year, and Cigna plans to leave by 2027.

Mark Bertolini stated, “Our superior operating performance and execution against the fundamentals of our strategy are accelerating the individual market.”

He added, “More people are moving between full- and part-time jobs, gig work, and retirement – a shift AI will accelerate. A durable individual market gives them greater choice and will power the future of American healthcare. Oscar’s consumer products, disciplined pricing, and scalable technology platform will capture this opportunity and position us for long-term profitable growth.”

Oscar reported a second-quarter net income of $361.8 million, or $1.10 per share, a stark contrast to the previous year’s loss of $228.4 million, or 89 cents per share. The first half of this year saw net income reach $1.04 billion, or $3.16 per share, compared to $46.9 million, or 17 cents per share, during the same period last year.

Oscar’s improved performance is attributed to its effective cost management for its growing membership base. Like other insurers in individual coverage, Oscar has faced rising medical expenses.

Oscar reported a decrease in its medical loss ratio to 79.2% in the second quarter, down from 91.1% a year earlier. This reduction was primarily due to disciplined pricing and favorable reserve developments.

The industry prefers medical benefit ratios below 90%, ideally in the mid-80s, a benchmark Oscar currently meets.

Looking forward, Oscar has raised its outlook for the rest of the year, including improvements in its medical loss ratio and earnings from operations.

Mark Bertolini commented, “Oscar delivered a strong second quarter and record profitability in the first half of 2026. The fundamentals of the business are strong, our performance is favorable to plan, and our improved 2026 outlook reflects that momentum. We are entering the second half of the year from a position of strength, with the technology, scale, and operating discipline to deliver profitable growth.”