Oscar Health Reports A Loss And Fewer Members Despite Operating In A Robust Obamacare Market

Oscar Health Tuesday reported a quarterly loss of $15 million thanks in part to tens of thousands of fewer sales of individual health insurance policies.

Oscar, which shook up its management ranks and hired former Aetna chief executive Mark Bertolini earlier this year, said total health plan membership dropped below 1 million to 970,543 in the second quarter ended June 30. That compares to nearly 1.04 million members in the year-ago period.

Oscar, which has sold individual coverage for years now and has still failed to turn a profit, was co-founded in 2012 by Mario Schlosser and Josh Kushner who both grew the health plan into one of the nation’s largest providers of individual coverage under the Affordable Care Act known as Obamacare. Until the shakeup in March of this year, Schlosser was CEO before transitioning to President of Technology, reporting to Bertolini.

Oscar, which still has Obamacare as its main business, said such individual membership and small group coverage was down more than 85,000 to 900,228 members. That compares to 986,000 members in the year ago quarter.

Oscar’s earnings report comes during a robust period of growth generally for companies in the business of selling individual coverage under the ACA. Cigna and Centene, for example, reported record growth in sales of Obamacare in their second quarter earnings reports.

Meanwhile, the Biden administration said earlier this year that a record of more than 16 million Americans have signed up for 2023 healthcare coverage that began Jan. 1, 2023 via the more than 30 states that use the federal HealthCare.gov marketplace and 18 state-based marketplaces.

Still, Oscar did narrow its losses from the year ago period, reporting a net loss of $15.4 million compared to $112 million in the year-ago period. That’s an improvement of more than $96 million year-over year.

Oscar said “total direct and assumed policy premiums were $1.6 billion in the quarter, down 3% year-over-year driven primarily by lower membership, partially offset by rate increases.” Total revenue was up by more than 50% to $1.52 billion in the second quarter compared to $1 billion in the year ago period.

“Our strong second quarter results demonstrate that our pricing discipline, renewed operational focus, and solid execution are driving meaningful impact across our business,” Bertolini said in a statement. “Based on strong year-to-date performance, we now expect to be towards the low-end of our MLR guidance and high-end of our full year Adjusted EBITDA guidance. We remain on track to deliver on our profitability targets and I am pleased with our progress to date.”