Oscar Health is posting impressive 53% revenue growth and is the industry growth leader in healthcare plans, but 93% revenue concentration in government premium payments creates existential policy risk, and business quality at 2.9 remains well below the 4.0 investability floor.
Thesis pillars
- Quality Floor Breach→Stable
- Revenue Growth 53pct Leadership→Stable
- Government Payer Concentration 93pct↓Deteriorating
- +1 more pillar — see the Why tab for full reasoning
Pillars as of Jul 3, 2026, based on the 10-K filed Feb 13, 2026· older than 90 days
Oscar Health, Inc. (OSCR) Stock Analysis
Breakout setup
Healthcare · Healthcare Plans
Hold if already holding. Not a fresh buy at $35.19, but acceptable to hold if already in. Reasons: Healthcare gov-payer cliff: 93% of revenue from CMS premiums (≥70% threshold). CMS rate-change exposure dominates.; Concentration risk — Customer: CMS premiums (93.0%).
Oscar Health offers ACA-compliant individual health plans in 18 states (20 for 2026), serving approximately 2.0 million effectuated members as of December 31, 2025. Revenue comes almost entirely from health insurance premiums, 93% collected from CMS via advanced premium tax... Read more
Hold if already holding. Not a fresh buy at $35.19, but acceptable to hold if already in. Reasons: Healthcare gov-payer cliff: 93% of revenue from CMS premiums (≥70% threshold). CMS rate-change exposure dominates.; Concentration risk — Customer: CMS premiums (93.0%). Chart setup: Golden cross, above all MAs, RSI 57, MACD bullish. Maintain position. Not compelling to add more. Score 6.8/10, moderate confidence.
Passes 5/9 gates (positive momentum, clean insider activity, news boost earnings 0.70, semi cycle peak clear, materials cycle peak clear). Fails on favorable risk/reward ratio and earnings proximity 0d<=7d and healthcare gov payer hard block. Suitability: aggressive.
About Oscar Health, Inc.
About Oscar Health, Inc.
Oscar Health served approximately 2.0 million effectuated members across 18 states in the individual ACA market as of December 31, 2025 — up from roughly 1.68 million at year-end 2024 — with Florida accounting for 1,179,934 members and Texas for 358,910. The company's +Oscar Campaign Builder platform served nearly 0.6 million additional client lives for provider and payor partners. Approximately 2,305 employees supported operations as of December 31, 2025.
Oscar earns revenue primarily from ACA health insurance premiums, 93% of which were collected directly from the Centers for Medicare & Medicaid Services via the APTC program and 7% from member payments in 2025. Members enroll principally through brokers using EDE platforms — the 10-K notes the vast majority of membership is acquired through the broker channel. In 2025, the company acquired three early-stage businesses (Lucie, Inc. / INSXCloud, IHC Specialty Benefits, and Healthinsurance.org) to build ICHRA and direct enrollment capabilities. The medical loss ratio and CMS risk adjustment transfers are the primary financial levers: base premiums are subject to risk adjustment based on the relative health status of members in a given state market, creating potential revenue volatility regardless of enrollment growth. Principal competitors include national carriers, regional carriers, Medicaid-focused insurers offering ACA marketplace products, and local Blue Cross plans.
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Oscar's premium revenue concentrates in a single federal payer relationship: 93% of 2025 premiums flowed from CMS under the APTC program, meaning subsidy policy changes — including the expiration of enhanced Advanced Premium Tax Credits or new program integrity rules — could materially affect effective premium per member. Florida represented 1,179,934 of 2,042,449 total members at year-end 2025, over half the membership base; premium rate changes require state and federal regulatory approval under the ACA, exposing the company to multi-jurisdictional timing risk across its geographically concentrated footprint.
See also: Healthcare · Healthcare Plans
From Oscar Health, Inc.'s most recent 10-K filing, extracted June 11, 2026.
Recent developments
updated Nov 5, 2026Recent Developments — Oscar Health, Inc.
Latest news
- NEWS Oscar Health Raises FY2026 Sales Guidance from $18.700B-$19.000B to $19.000B-$19.300B vs $18.732B Est — benzinga Nov 5, 2026 positive
- NEWS Are Finance Stocks Lagging Oscar Health (OSCR) This Year? - Yahoo Finance — Yahoo Finance Nov 2, 2026 negative
- NEWS Oscar Health, Inc. (OSCR) Increases Despite Market Slip: Here's What You Need to Know - Yahoo Finance — Yahoo Finance Oct 29, 2026 neutral
- NEWS Lucie and CHOICE Broaden the Growth Runway for Oscar Health - TradingView — TradingView Oct 29, 2026 positive
- NEWS Oscar Health (OSCR) Set to Release Quarterly Earnings on Thursday - MarketBeat — MarketBeat Oct 29, 2026 neutral
Latest item Nov 5, 2026 · Generated 2026-11-05T11:29:01Z.
Upcoming dated catalysts
Thesis
Key Metrics
Quality Signals
Options Flow
Concentration Risks(10-K Item 1A)
- HIGHCustomerCMS premiums93%10-K Item 1: '93% of premiums were earned directly from CMS and 7% were from our members'
- HIGHGeographicFlorida10-K Item 1: 'Florida| 1,179,934 ... Total| 2,042,449'
Material Events(8-K, last 90d)
- 2026-06-02Item 5.02MEDIUMMario Schlosser transitioned from President of Technology and CTO to Co-Founder & Advisor to the CEO effective June 1, 2026 per amended employment agreement of May 29, 2026. Base salary reduced to $370,000; no longer eligible for annual bonus or LTI awards. Remains on board of directors.SEC filing →
Model-generated analysis — not investment advice. Not a registered investment advisor. Past performance does not guarantee future results. How we score · Editorial policy
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Rating Breakdown
1 floor-breaker·2 ceiling hits
Technicals below the gate floor. Component breakdown shows what dragged the score down.static
Price Targets
Position Sizing
Risk Alerts
Earnings
Verdict History
Frequently Asked Questions
Hold if already holding. Not a fresh buy at $35.19, but acceptable to hold if already in. Reasons: Healthcare gov-payer cliff: 93% of revenue from CMS premiums (≥70% threshold). CMS rate-change exposure dominates.; Concentration risk — Customer: CMS premiums (93.0%). Chart setup: Golden cross, above all MAs, RSI 57, MACD bullish. Maintain position. Not compelling to add more. Analyst target $31.67 reached (−10.0%), stop $32.73 (−7.5%), A.R:R -0.7:1. Score 6.8/10, moderate confidence.
Analyst target $31.67 reached (−10.0% from $35.19); no take-profit level is published. Analyst target $31.67 reached (−10.0%), stop $32.73 (−7.5%), A.R:R -0.7:1. Stop-loss: $32.73.
Healthcare gov-payer cliff: 93% of revenue from CMS premiums (≥70% threshold). CMS rate-change exposure dominates.; Concentration risk — Customer: CMS premiums (93.0%); Concentration risk — Geographic: Florida.
Oscar Health, Inc. trades at a P/E of 27.3 (forward 15.8). TrendMatrix value score: 7.3/10. Verdict: Hold.
19 analysts rate OSCR, with a consensus score of 3.6/5. 10 analysts publish price targets averaging $36.
What does Oscar Health, Inc. do?Oscar Health offers ACA-compliant individual health plans in 18 states (20 for 2026), serving approximately 2.0 million...
Oscar Health offers ACA-compliant individual health plans in 18 states (20 for 2026), serving approximately 2.0 million effectuated members as of December 31, 2025. Revenue comes almost entirely from health insurance premiums, 93% collected from CMS via advanced premium tax credits and 7% directly from members. The +Oscar Campaign Builder platform additionally serves nearly 0.6 million client lives for provider and payor partners.