Oscar Health Plans Major Obamacare Expansion Over Next Three Years
Oscar Health plans to expand its individual and small business coverage offerings by 400 to 600 counties by 2029 as the health insurer has become more profitable.
The announcement Wednesday by Oscar on its annual investor day comes a month after the company reported more than $1 billion in net income for the first half of the year.
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, which is in 573 counties and 20 states this year, has 2.9 million health plan members and has effectively navigated the Affordable Care Act’s individual market, also known as Obamacare even as major competitors like CVS Health’s Aetna and Cigna announce their exits from the business. The expansion unveiled Wednesday includes adding South Carolina to its market footprint for the 2027 health benefit year.
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 in April disclosed that the insurer will exit Obamacare in 2027. Oscar executives have said they have grown in part by attracting members from health insurers that have exited in the individual health insurance business.
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.
Company executives will be providing more details on its improving cost picture Wednesday as well as its outlook for costs. In addition, Oscar plans to update investors on the growth of its new “Lucie” consumer health marketplace designed to connect consumers and brokers to “every major” individual health insurance plan as well as supplemental and ancillary coverage beyond the plans it sells.