Oscar Health, Inc. — Cyborg Score 6/10

Solid
Health Insurance

Strategic Profile

Oscar Health targets profitability in 2026 driven by record membership growth, improved margins, disciplined cost management, and AI-driven operational efficiencies. Oscar's market share across its footprint increased from 17% in 2025 to 30% in 2026. The company emphasized plan design and distribution efforts ahead of the enhanced premium tax credit expiration, including the creation of new Bronze and Gold plans and a 60% expansion in broker partnerships.

Cyborg Score Rationale

Oscar expects >60% revenue growth in 2026 to $18.85bn at midpoint guidance, a return to profitability, and significant operating earnings improvement. However, Oscar expects around 20% risk adjustment transfers in 2026, signaling persistent pressure and volatility from the risk-adjustment regime. Execution risk remains material on margin targets.

Top Insights

  • Bertolini reported 3.4 million members as of February 1, 2026, and the company expects to start the second quarter with approximately 3 million paid members, which would represent a 58% increase year over year.
  • For 2026, Oscar guides to total revenue of $18.7–$19.0 billion, a medical loss ratio of 82.4–83.4%, an SG&A ratio of 15.8–16.3%, and $250–$450 million of earnings from operations, implying a planned return to profitability.
  • The company was forced to increase its Q4 risk-adjustment accrual by $275 million after data showed members were healthier than market assumptions.
  • Oscar Health, trading on the New York Stock Exchange under the ticker OSCR, is a technology-driven health insurance company headquartered in New York, New York.

Named Competitors

  • UnitedHealthcare — Largest US health insurer with diversified portfolio
  • Anthem — Major health insurance provider covering 40M+ members
  • Aetna — Integrated health insurance and pharmacy benefits

Recent Developments

  • (February 2026) Oscar Health entered into a $475.0 million secured three-year revolving credit facility
  • (February 2026) Company reported 3.4 million members and expects 3 million paid members by Q2 2026, representing 58% YoY growth
  • (February 2026) Oscar guided to $18.7–$19.0 billion 2026 revenue and record membership of ~3.4 million, with planned return to profitability

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