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
Oscar Health, Inc. (OSCR) Stock Analysis
Healthcare · Healthcare Plans
Hold if already holding. Not a fresh buy at $30.48, 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 $30.48, 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: No clear chart pattern; technical signals are mixed. Maintain position. Not compelling to add more. Score 6.5/10, moderate confidence.
Passes 2/8 gates (semi cycle peak clear, materials cycle peak clear). Fails on weak momentum and favorable risk/reward ratio and earnings proximity 6d<=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.
Show full overview
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 2026-10-29Recent Developments — Oscar Health, Inc.
Latest news
- NEWS Oscar Health Stock Analysis: Buy or Sell? - The Globe and Mail — The Globe and Mail neutral
- NEWS Oscar Health Inc (OSCR) Shares Surge 5.9% -- What GF Score of 76 Tells Investors - GuruFocus — GuruFocus positive
- NEWS Oscar Health’s Q2 Earnings Call: Our Top 5 Analyst Questions - StockStory — StockStory neutral
- NEWS OSCR Stock Hits 5-Year High: Oscar Sees 'Healthy Tailwinds' In 2026 On Potential Upside To Guidance - Stocktwits — Stocktwits positive
- NEWS Q2 Earnings Roundup: Oscar Health (NYSE:OSCR) And The Rest Of The Health Insurance Providers Segment - The Globe and Mai — The Globe and Mail neutral
Generated 2026-10-29T12:43:34Z.
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
Show full disclosure ▾Hide full disclosure ▴
About TrendMatrix. TrendMatrix is a publisher of general securities research and market commentary. We publish on a regular schedule. All content is the same for every subscriber in a tier — we do not provide personalized investment advice and we do not take into account any individual subscriber's financial situation, investment objectives, risk tolerance, tax situation, or holdings.
Not investment advice. TrendMatrix is not a registered investment adviser. Our content is for informational and educational purposes only. Consult your own licensed investment adviser, broker, or tax professional before making any investment decision.
Conflicts and positions. People who build TrendMatrix, or entities they control, may hold positions, long or short, in securities it covers, and may trade them at any time. Positions are not disclosed individually. Verdicts are generated by an automated model applied by the same rules to every covered stock, and are not adjusted for any position held by the people who build TrendMatrix. We do not accept payment from issuers for coverage.
No paid promotion. TrendMatrix does not accept payment from any issuer, broker, or third party in exchange for coverage of any security.
No fiduciary duty. No fiduciary, advisory, or agency relationship is created between you and TrendMatrix by reading our content or subscribing to our service.
Performance. Past performance is not indicative of future results. Performance figures reflect the published model only and do not reflect any individual subscriber's actual results.
Rating Breakdown
1 floor-breaker·1 ceiling hit
Momentum 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 $30.48, 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: No clear chart pattern; technical signals are mixed. Maintain position. Not compelling to add more. Analyst target $31.67 (+3.9%), stop $28.80 (−5.8%), A.R:R 0.4:1. Score 6.5/10, moderate confidence.
Analyst target: $31.67 (+3.9% upside). Analyst target $31.67 (+3.9%), stop $28.80 (−5.8%), A.R:R 0.4:1. Stop-loss: $28.80.
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 23.6 (forward 13.7). TrendMatrix value score: 8.1/10. Verdict: Hold.
19 analysts cover OSCR with a consensus score of 3.6/5. Average price target: $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.