Health insurer Oscar Health swung to a $679 million first quarter profit – the highest in company history – as its health plan membership jumped more than 50% and medical costs eased, the company said Wednesday May 6.

Oscar Health

Health insurer Oscar Health swung to a $679 million first quarter profit – the highest in company history – as its health plan membership jumped more than 50% and medical costs eased.

Oscar, which grew to 3.2 million health plan members as one of the nation’s largest providers of individual coverage under the Affordable Care Act, on Wednesday reported net income of $679 million, or $2.07 per diluted share. That compares to $275.3 million, or 92 cents in the first quarter of 2025.

Founded in 2012, Oscar had yet to turn a profit for a full year until 2024, but Mark Bertolini -- the former chief executive officer of Aetna who was tapped as Oscar’s top executive in March of 2023 and his team – have delivered on their promises as they remain bullish on the individual health insurance market even as rivals are retreating. This year’s first quarter profit was several times what the company made last year and the year before.

Oscar’s revenue rose 53% to $4.6 billion from $3 billion in the year-ago quarter thanks to the 56% increase in health plan enrollment from 2 million last year after Oscar expanded sales of its health insurance products into new markets for this year.

Oscar now offers coverage in 573 counties across 93 metropolitan markets after expanding into two new states - Alabama and Mississippi - for this year, putting the company’s Obamacare products in 20 U.S. states for the 2026 health benefit year.

“Oscar Health drove solid first-quarter performance with significant year-over-year improvements across our core metrics,” Bertolini said Wednesday in a statement accompanying earnings. “We are reaffirming our guidance and remain on track to significantly expand margins and achieve meaningful profitability in 2026.”

Like other health insurers, Oscar’s medical costs eased in the first quarter and were much lower than rivals that had medical loss ratios north of 85%. The medical loss ratio, which is the percentage of premium revenue that goes toward medical costs, was 70.5% for the first quarter of 2026 compared to 75.4% for the first quarter of 2025.

Oscar’s medical loss ratio was 95.4% in the fourth quarter of last year. That compares to 88.1% in the fourth quarter of 2024.

Health insurers historically have wanted that benefit expense ratio percentage in the mid to low 80s but that’s been largely unachievable for most other health insurers for the last year or so in part because insurers say Americans, particularly older adults, have a pent up demand for healthcare following the Covid-19 pandemic when many patients delayed treatment.

“The decrease was primarily due to our disciplined pricing strategy, claims and risk adjustment seasonality from metal and new member mix, and favorable prior period reserve development,” Oscar said in its earnings report.