Total membership grew 28% to 2,027,148 members, led by a 32.5% jump in individual and small group plans to 2,017,058 members. The former partnership channel contracted to 10,090 members from 58,293 a year ago. The medical loss ratio rose sharply to 91.1% from 79.0%, driven by higher average market morbidity and a negative net risk adjustment transfer accrual. Selling, general and administrative expense ratio improved to 18.7% from 19.6% due to lower exchange fees and fixed-cost leverage, partially offset by higher risk adjustment costs as a percentage of premiums. Oscar Health reported second-quarter GAAP revenue of $2.86 billion, a 29.0% increase year-over-year driven by higher plan memberships. The company recorded a net loss of $228.4 million, compared with net income of $56.2 million in the prior-year period. GAAP earnings per share were a loss of $0.89, missing consensus estimates by $0.08 per share. Adjusted EBITDA swung to a $199.4 million loss from a $104.1 million profit a year earlier, reflecting elevated claims costs and risk transfer accruals. Management reaffirmed full-year revenue guidance of $12.0 billion to $12.2 billion and expects a medical loss ratio of 86%–87%, an SG&A ratio of 17.1%–17.6%, an operating loss between $200 million and $300 million, and an adjusted EBITDA loss of approximately $120 million. Executives project market stabilization in 2026 and a return to profitability. Key metrics to monitor include quarterly trends in claims costs, risk adjustment payments, membership quality and pricing actions for the 2026 plan year.
Total membership grew 28% to 2,027,148 members, led by a 32.5% jump in individual and small group plans to 2,017,058 members. The former partnership channel contracted to 10,090 members from 58,293 a year ago. The medical loss ratio rose sharply to 91.1% from 79.0%, driven by higher average market morbidity and a negative net risk adjustment transfer accrual. Selling, general and administrative expense ratio improved to 18.7% from 19.6% due to lower exchange fees and fixed-cost leverage, partially offset by higher risk adjustment costs as a percentage of premiums. Oscar Health reported second-quarter GAAP revenue of $2.86 billion, a 29.0% increase year-over-year driven by higher plan memberships. The company recorded a net loss of $228.4 million, compared with net income of $56.2 million in the prior-year period. GAAP earnings per share were a loss of $0.89, missing consensus estimates by $0.08 per share. Adjusted EBITDA swung to a $199.4 million loss from a $104.1 million profit a year earlier, reflecting elevated claims costs and risk transfer accruals. Management reaffirmed full-year revenue guidance of $12.0 billion to $12.2 billion and expects a medical loss ratio of 86%–87%, an SG&A ratio of 17.1%–17.6%, an operating loss between $200 million and $300 million, and an adjusted EBITDA loss of approximately $120 million. Executives project market stabilization in 2026 and a return to profitability. Key metrics to monitor include quarterly trends in claims costs, risk adjustment payments, membership quality and pricing actions for the 2026 plan year.