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Home » Oscar Health Reports Another Big Profit As Obamacare Member Costs Ease

Oscar Health Reports Another Big Profit As Obamacare Member Costs Ease

By News RoomAugust 6, 2026No Comments3 Mins Read
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Oscar Health Reports Another Big Profit As Obamacare Member Costs Ease
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Health insurer Oscar Health swung to a $361 million second quarter profit while eclipsing $1 billion in net income for the first six months of the year as health plan membership rose and medical costs eased.

Oscar, which has grown to 2.9 million health plan members from a little more than 2 million a year ago, is one of the nation’s largest providers of individual coverage under the Affordable Care Act. Thus, Oscar’s revenues jumped 70% year over year to $4.9 billion in the second quarter.

Founded in 2012, Oscar had struggled to turn consistent quarterly profits, but Mark Bertolini — the former chief executive officer of Aetna who was tapped as Oscar’s top executive in March of 2023 — and his team – have delivered on their promises as they remain bullish on the individual health insurance.

Oscar’s growth in Obamacare and ability to contain health plan costs of its members comes as rivals exit the individual market. CVS Health’s Aetna left the individual market effective this year and Cigna will exit Obamacare in 2027.

“Our superior operating performance and execution against the fundamentals of our strategy are accelerating the individual market,” Bertolini said in a statement accompanying Oscar’s quarterly earnings.

“More people are moving between full- and part-time jobs, gig work, and retirement – a shift AI will accelerate,” he added. “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 on Thursday reported second quarter net income of $361.8 million, or $1.10 per share, compared to a loss of $228.4 million, or a loss of 89 cents a share, in the second quarter of last year. For the first six months of this year, Oscar reported net income of $1.04 billion, or $3.16 per share, compared to just $46.9 million, or 17 cents a share, in the first six months of 2025.

A key reason Oscar is performing better is due to the company’s ability to control costs of its growing number of health plan members. Like other health insurers, particularly those selling individual coverage, Oscar has been battling the rising medical expenses of its health plan members.

But Oscar reported its medical loss ratio, which is the percentage of health plan premium spent on medical care, decreased to 79.2% in the second quarter of this year compared to to 91.1% for the second quarter of 2025, which“included the entire first half impact of 2025 risk adjustment true-up driven by higher average market morbidity,” Oscar said in its earnings report. “The decrease was primarily driven by our disciplined pricing strategy and $164 million of favorable prior period reserve development.”

The industry and its analysts would prefer medical benefit ratios to be below 90% and into the mid 80s, so Oscar has achieved that measure for the time being.

Looking ahead, Oscar raised its outlook for the rest of the year on several measures including its medical loss ratio and earnings from operations.

“Oscar delivered a strong second quarter and record profitability in the first half of 2026,” Bertolini said. “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.”

Aetna Cigna CVS Health Obamacare oscar health
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