A maker of individual-market health insurance plans sold through the Affordable Care Act marketplaces in 18 states, Oscar also runs the +Oscar technology platform that partners use to engage their members. Founded in 2012 by Mario Schlosser, Joshua Kushner, and Kevin Nazemi after Schlosser struggled to navigate the healthcare system following his child's birth, the company is a cloud-native tech play aimed at making insurance feel less confusing. The name "Oscar" was deliberately chosen to sound like a friendly person you could talk to, rather than a faceless financial institution.
Oscar Health swung to a $361.8M Q2 net profit as disciplined pricing and favorable reserve development drove the Medical Loss Ratio down to 75.0%.
Oscar Health returned to profitability in the second quarter after a year-ago loss driven by risk adjustment charges. rose 70.4% to $4.88 billion and was $361.8 million, as the Medical Loss Ratio improved 16 points to 75.0% on disciplined pricing and favorable . The company is now solidly profitable at scale, but the expiration of enhanced ACA subsidies remains a structural risk to the individual market it depends on.
Key takeaways
was $361.8 million, a reversal from a $228.4 million loss a year earlier and down 46.7% from the seasonally high $679.0 million profit in Q1 2026.
The Medical Loss Ratio improved to 75.0% from 91.1% in Q2 2025, driven by disciplined pricing actions and favorable , bringing the H1 2026 MLR to 75.0%.
rose 70.4% to $4.88 billion, driven by a 46% increase in to approximately 3.0 million and rate increases, partially offset by higher accruals.
Section summaries
Management's Discussion and Analysis
Premium revenue surged 62% YoY to $9.4B on 46% membership growth, driving a swing to $1.0B net income.
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Total rose 61% to $9.5B for H1 2026, driven by a 46% increase in effectuated members to ~3.0M and rate increases, partially offset by higher (20% of direct premium).
was $2.09 billion, up 311% , and insurance subsidiaries held $9.7 billion in cash and investments with an estimated $994 million in excess .
The SG&A expense ratio improved 250 to 14.7% for the first half, as fixed costs leveraged across the larger membership base despite a 37% increase in absolute SG&A costs.
Management warns that the expiration of enhanced APTC subsidies and new CMS program integrity rules could contract the ACA marketplace and affect future membership and market morbidity.
What changed
The Q2 2025 risk adjustment shock that drove a $228.4M net loss and a 91.1% MLR did not repeat; disciplined pricing and favorable reserve development brought the Q2 2026 MLR down to 75.0%, settling the key watch item from the prior year.
The membership increase flagged in Q1 2026 continued, with reaching ~3.0M, up 46% , confirming the growth trajectory after the 2025 enrollment window changes.
The enhanced APTC expiration risk, flagged in every filing since FY2024, remains unresolved and is now cited alongside new CMS program integrity rules as a threat to future ACA marketplace stability.
What to watch
Q3 2026 Medical Loss Ratio against the 75.0% H1 level as prior-period development and the 2026 risk adjustment accrual settle.
Membership trajectory through the 2026 enrollment window under expired enhanced APTCs and new CMS program integrity rules.
Effect of enhanced APTC expiration on market morbidity and risk adjustment accruals in the second half of 2026.
Deployment of the $994 million in excess at insurance subsidiaries, including the new Florida HMO.
improved to 75.0% from 83.0% in H1 2025, driven by disciplined pricing and favorable prior period reserve development.
improved 250 to 14.7% on greater fixed cost and disciplined expense management, despite a 37% increase in absolute SG&A costs from higher volume-driven expenses.
attributable to Oscar Health swung to a $1.04B profit from $46.9M, supported by a $4.7B operating cash inflow from higher premiums.
Liquidity remains robust with $9.7B in cash and investments at insurance subs, which hold an estimated $994M in excess statutory capital, and a new $475M undrawn .
Quantitative and Qualitative Disclosures About Market Risk
Market risk represents the risk of loss that may impact our financial position due to adverse changes in financial market prices and rates. Our market risk exposure is primarily a result of exposure due to potential changes in interest rates and/or inflation and the resulting im…
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Market risk represents the risk of loss that may impact our financial position due to adverse changes in financial market prices and rates. Our market risk exposure is primarily a result of exposure due to potential changes in interest rates and/or inflation and the resulting impact on investment income and interest expense. We do not hold financial instruments for trading purposes.
Interest Rate Risk
We are subject to interest rate risk in connection with the fair value of our investment portfolio, which consists of U.S. Treasury and agency securities, corporate notes, asset-backed securities, and certificates of deposit. Our primary market risk exposure is driven by changes to prime rate based interest rates. Interest rate risk is highly sensitive due to many factors, including U.S. monetary and tax policies, U.S. and international economic factors, and other factors beyond our control. Assuming a hypothetical and immediate 1% increase in interest rates on June 30, 2026, the fair value of our investments would decrease by approximately $51.4 million. Any declines in interest rates over time would reduce our investment income.
The information required under this Part II, Item 1 is set forth in “Note 12 - Commitments and Contingencies” to the Condensed Consolidated Financial Statements included elsewhere in this Quarterly Report on Form 10-Q. Given that such proceedings are subject to uncertainty, ther…
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The information required under this Part II, Item 1 is set forth in “Note 12 - Commitments and Contingencies” to the Condensed Consolidated Financial Statements included elsewhere in this Quarterly Report on Form 10-Q.
Given that such proceedings are subject to uncertainty, there can be no assurance that such legal proceedings, either individually or in the aggregate, will not have a material adverse effect on our business, results of operations, financial condition or cash flows.
The risks that we believe are material to our investors are disclosed in Part I, Item 1A, of our Annual Report on Form 10-K for the year ended December 31, 2025.
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The risks that we believe are material to our investors are disclosed in Part I, Item 1A, of our Annual Report on Form 10-K for the year ended December 31, 2025.