Oscar Health announced the launch of new affordable health insurance plans for individuals, families, and small businesses that will take effect on January 1, 2026. The plans cover 11 Central Florida counties—Brevard, Citrus, Flagler, Hernando, Lake, Marion, Orange, Osceola, Polk, Seminole, and Volusia—and enrollment opens on November 1, 2025. Members will have access to a broad network that includes AdventHealth, HCA Healthcare, and Orlando Health, giving the company a strong provider base in the region.
The expansion comes amid a period of rapid revenue growth for Oscar Health. In Q2 2025 the company reported total revenue of $2.9 billion, up 29% from $2.2 billion in Q2 2024, and membership exceeding two million. However, the company also posted a net loss of $228.4 million, a sharp reversal from the $56.2 million profit reported in Q2 2024. The loss is largely attributable to a higher medical loss ratio (MLR) of 91.1% versus 79.0% in the prior year, driven by increased average market morbidity and higher risk‑adjustment transfers. Despite the loss, Oscar Health reaffirmed its full‑year 2025 revenue guidance at $12.0 billion to $12.2 billion and projected a 2026 return to profitability.
The Orlando launch is a key component of Oscar Health’s strategy to capture market share in the ACA marketplace. By adding 11 counties to its footprint, the company can tap a population of roughly 4.5 million residents, many of whom are currently uninsured or underinsured. The move also positions Oscar to benefit from the state’s Medicaid expansion and the growing demand for tech‑enabled, customer‑centric plans. The company’s focus on data‑driven pricing and member experience is expected to support long‑term growth, even as it navigates higher medical costs and regulatory changes.
CEO Mark Bertolini emphasized that the company is “building a scalable, technology‑first platform that can deliver high‑quality care at a lower cost.” He noted that the 2026 pricing strategy will reflect the higher acuity of the individual market and that the company is resubmitting rate filings to align with updated risk scores. Bertolini also highlighted the company’s investment in AI‑powered member tools, such as the “Oswell” health assistant, as a way to improve member engagement and reduce utilization costs.
Investors responded positively to the upward revision of Oscar Health’s 2025 revenue guidance, which exceeded analyst expectations and signaled confidence in the company’s growth trajectory. The market reaction underscored the importance of revenue expansion for the company’s long‑term path to profitability, even as it continues to manage higher medical costs and a tightening margin environment.
In summary, Oscar Health’s new plans in Central Florida represent a strategic push to broaden its ACA presence and drive membership growth. While the company faces headwinds from rising medical costs and a higher MLR, its robust revenue growth, technology investments, and proactive pricing strategy position it to achieve profitability in 2026 and sustain long‑term competitive advantage.
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