Oscar Health Thursday reported a $137 million third quarter loss but predicts “a return to profitability” as the health insurance industry works its way through a period of rising costs and Washington gridlock.
Oscar has more than 2 million health plan members as one of the nation’s largest providers of individual coverage under the Affordable Care Act, also known as Obamacare. Oscar’s total membership was up 28% to more than 2.1 million compared to the third quarter of last year, helping total revenue rise 23% to nearly $2.9 billion in the third quarter.
But Oscar reported a third quarter loss of $137.5 million, or 53 cents a share, which compares to a loss of $54.6 million, or 22 cents in the year-ago period.
Oscar is among a parade of health insurers that provide government-subsidized health insurance and have been hit hard by higher costs, lowering their profit forecasts and announcing plans to increase rates next year to cover the costs of a sicker pool of patients.
In Oscar’s case, the company sees a return to a positive net income next year by “balancing membership and profitability,” the company said in a statement accompanying its earnings report.
“We resubmitted rate filings in states covering close to 99% of current membership for 2026,” the company said in a statement. “Our rate filings reflect elevated (cost) trend, significantly higher market morbidity in 2025, the expiration of enhanced premium tax credits, and program integrity initiatives.”
Looking ahead, Oscar also sees an opportunity to gain market share in part because other companies are leaving the market. CVS Health’s Aetna is pulling out of Obamacare altogether for next year while UnitedHealth Group’s UnitedHealthcare and other companies are retreating in certain markets.
But Oscar chief executive Mark Bertolini sees an individual market that continues to expand, particularly from workers in a service economy.
“The individual market aligns with major macroeconomic, workforce, and consumer trends. More Americans work in the service economy than ever before,” Bertolini said in a statement accompanying the company’s third quarter earnings report. “More businesses want affordable benefit options. More people want greater choice. Oscar is ahead of the demand and we are creating the future of individual healthcare for all Americans.”
