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Oscar Health Loss Widens as Membership Tops 2.1 Million

Higher market morbidity drives a pricing reset aimed at a 2026 return to profit.

Overview

  • Q3 revenue rose 23% to $2.99 billion but missed Wall Street estimates as GAAP net loss widened to $137.5 million, or $0.53 per share.
  • Key margin metrics deteriorated with a medical loss ratio of 88.5% and an adjusted EBITDA loss of $101.5 million, reflecting larger risk-adjustment accruals.
  • Total membership increased about 28% year over year to roughly 2.12 million, boosting scale while changing the risk profile.
  • Oscar resubmitted 2026 rate filings covering close to 99% of current membership, signaling roughly 28% average increases and factoring potential loss of enhanced premium tax credits and program integrity impacts.
  • Management reaffirmed 2025 sales guidance of $12.0–$12.2 billion and targets positive net income in 2026, eyeing share gains as rivals including Aetna exit parts of the ACA market.