Oscar Health Raises 2026 Operating Profit Outlook

The Tip Desk · August 6, 2026 · 3 min read

The insurer lifted full-year earnings from operations to $500 million–$700 million after $388.6 million of second-quarter operating profit.

Oscar Health, Inc. (OSCR) raised its full-year 2026 earnings-from-operations outlook to $500 million–$700 million from $250 million–$450 million, and cut its medical loss ratio and SG&A expense ratio ranges after a second quarter in which the healthcare technology company posted $388.6 million of operating profit.

The company also lowered the medical loss ratio outlook to 81.5%–82.5% from 82.4%–83.4% and the SG&A expense ratio outlook to 15.6%–16.1% from 15.8%–16.3%. Total revenue guidance remained $18.7 billion–$19.0 billion.

Chief executive Mark Bertolini said Oscar delivered record profitability in the first half of the year and is raising full-year 2026 guidance.

For the three months ended June 30, 2026, total revenue was $4.88 billion, compared with $2.86 billion a year earlier. The year-over-year increase was driven by higher membership and rate increases, partially offset by a larger net risk adjustment transfer accrual.

The medical loss ratio was 79.2% in the second quarter, versus 91.1% a year earlier. The year-over-year decline reflected disciplined pricing and $164 million of favorable prior-period reserve development; the 2025 quarter included the entire first-half impact of the 2025 risk adjustment true-up driven by higher average market morbidity.

The SG&A expense ratio was 14.2%, versus 18.7% a year earlier. The decline reflected disciplined expense management, greater fixed-cost leverage, and lower risk adjustment as a percentage of premium.

Net income attributable to Oscar Health was $361.8 million, or $1.10 a share, versus a net loss of $228.4 million, or $0.89 a share, a year earlier. Adjusted EBITDA was $415.3 million, versus an Adjusted EBITDA loss of $199.4 million.

Effectuated membership was 2,963,002 as of June 30, 2026, down from 3,174,489 as of March 31. All remaining members were in Individual and Small Group. Cigna+Oscar membership was zero after the company did not renew the co-branded small-group arrangement after its initial term ended.

The second-quarter operating result followed a first quarter in which earnings from operations were $704.1 million and the medical loss ratio was 70.5%.

For the six months ended June 30, 2026, total revenue was $9.53 billion, versus $5.91 billion a year earlier. The medical loss ratio was 75.0% and the SG&A expense ratio was 14.7%. Earnings from operations were $1.09 billion, versus $66.6 million. Net income attributable to Oscar Health was $1.04 billion, or $3.16 a share. Adjusted EBITDA was $1.14 billion.

Cash and cash equivalents were $4.08 billion at June 30, 2026, and short-term investments were $4.48 billion. Total assets were $11.23 billion. Payables to CMS were $6.10 billion.

Bertolini said more people are moving between full- and part-time jobs, gig work, and retirement, a shift AI will accelerate, and that Oscar’s consumer products, disciplined pricing, and scalable technology platform will capture the opportunity.