Oscar Health, Inc

Oscar Health, Inc (NYSE: OSCR) operates as a healthcare technology company anchored by a fully integrated, end-to-end technology platform. The Company delivers value through its insurance operations and the +Oscar technology platform, with a primary focus on the individual health insurance market. Its plans are designed for individuals and families purchasing coverage through Affordable Care Act–established health insurance exchanges, administered by the federal government, alongside select state-run marketplaces.

Strategic Reset and Business Positioning

• Recalibration of Strategic Priorities: Management characterized 2025 as a reset year for the individual health insurance market, marked by decisive strategic actions aimed at restoring profitability. Investments in affordable product offerings, technology-enabled capabilities such as agentic AI, and member experience enhancements underpinned record membership growth. Looking ahead, the Company has guided toward significantly improved financial performance in 2026, supported by expected revenue exceeding USD 18 billion and a structurally lower cost base.

Membership Expansion and Market Penetration

• Member Base Scaling and Portfolio Focus: Operational execution during the year resulted in a significant expansion of the Company’s membership base, reaching approximately 3.4 million members at peak and closing the year with over 2.0 million covered lives. Growth was primarily driven by increased adoption of Individual and Small Group plans, reflecting stronger consumer traction and improved product-market alignment following portfolio simplification and targeted distribution strategies.

Revenue Growth and Top-Line Performance (for the year ended year ended December 31, 2025)

• Top-Line Momentum Supported by Volume Growth: Oscar Health, Inc. delivered strong top-line expansion in 2025, supported by continued scale-up across its Individual and Small Group offerings. Total revenue for the full year reached approximately USD 11.7 billion, reflecting a meaningful increase from USD 9.2 billion in the prior year, driven primarily by higher membership levels. Fourth-quarter revenue similarly showed year-on-year growth, underscoring sustained demand across the Company’s core markets.

Medical Cost Trends and Loss Ratio Movement

• Claims Intensity and Underwriting Pressure: The Company experienced elevated medical cost pressure during the year, reflected in a higher medical loss ratio relative to 2024. This increase was primarily attributable to higher-than-anticipated market morbidity and increased healthcare utilization, which were not fully mitigated by risk adjustment mechanisms. These dynamics weighed on underwriting margins and contributed to weaker operating profitability for the period.

Operating Expense Discipline and Efficiency Gains

• Overhead Rationalisation and Operating Leverage: Despite higher medical costs, Oscar Health demonstrated continued progress in managing operating expenses. The SG&A expense ratio declined year over year, benefiting from fixed-cost leverage, reduced exchange fee rates, and disciplined cost controls. These efficiency gains highlight the scalability of the Company’s operating model and management’s focus on maintaining organizational cost discipline amid revenue growth.

Profitability and Earnings Performance

• Near-Term Profitability Drag: Oscar reported a loss from operations of approximately USD 396 million for the full year 2025, compared with operating earnings of USD 57 million in 2024. Net loss attributable to shareholders amounted to about USD 443 million, reversing the modest net income recorded in the prior year. Adjusted EBITDA also declined to a loss of roughly USD 280 million, reflecting the combined effect of higher medical costs and risk adjustment dynamics despite revenue growth.

Balance Sheet Strengthening and Forward Outlook

• Capital Structure Actions and Earnings Recovery Trajectory: From a financial position standpoint, Oscar significantly strengthened its liquidity during the year. Cash, cash equivalents, and short-term investments increased materially, supported by strong operating cash inflows and financing activities. Total assets rose to approximately USD 6.3 billion as of December 31, 2025, while the Company also enhanced balance sheet flexibility through the establishment of a USD 475 million secured revolving credit facility in early 2026.

Key Risks:

• Medical Cost Volatility: Higher-than-expected member utilization or adverse shifts in market morbidity could sustain pressure on the medical loss ratio and delay margin normalization.
• Risk Adjustment Uncertainty: Variability in federal risk adjustment outcomes or estimation inaccuracies may lead to earnings volatility and weaker profitability conversion.
• Regulatory and Policy Exposure: Changes to Affordable Care Act regulations, subsidy structures, or exchange rules could affect enrollment growth, pricing flexibility, and revenue stability.
• Execution Risk on 2026 Outlook: Failure to translate scale benefits, technology investments, and cost discipline into operating leverage may temper the anticipated improvement in 2026 financial performance.

Technical Observation (on the daily chart):

• Trend Structure: The stock has transitioned into a medium-term downtrend, marked by a sequence of lower highs since the October peak near USD 23.8. Price action has remained capped below declining moving averages, indicating weakening trend strength.
• Moving Averages: The 20-day moving average (USD 15.08) remains below the 50-day moving average (USD 15.67), confirming a bearish crossover. Price is trading below both averages, suggesting rallies are being sold into rather than extended.
• Momentum: The 14-day RSI is hovering around 24, placing the stock firmly in oversold territory. While this raises the probability of a short-term technical bounce, the lack of positive divergence suggests rebounds may be corrective rather than trend-reversing.
• Volume Profile: Trading volumes have remained relatively subdued in recent sessions, indicating limited conviction from buyers at current levels. The absence of a volume spike reduces the likelihood of a durable reversal in the near term.

Oscar Health’s 2025 performance underscores a constructive operational inflection, with strong revenue growth and record membership validating the Company’s product positioning and market relevance. While profitability was temporarily pressured by elevated medical costs and risk adjustment dynamics, disciplined SG&A management, improving scale economics, and a significantly strengthened liquidity position highlight effective execution. Management’s strategic reset—focused on affordable product innovation, technology enablement, and member experience—has materially expanded the customer base and positioned the business for a meaningful improvement in financial performance, supported by a clear and confident outlook for 2026.

Supported by a growing customer base, strengthening balance sheet, and sustained earnings momentum, a ‘Buy’ rating has been given Oscar Health, Inc (NYSE: OSCR) at the closing market price of USD 12.66 as of Feb 09,2026. 

Individuals can evaluate the stock based on the support and resistance levels provided in the report in case of keen interest taking into consideration the risk-reward scenario. 

Markets are trading in a highly volatile zone currently due to certain macro-economic issues and prevailing geopolitical tensions. Therefore, it is prudent to follow a cautious approach while investing.

Related Risk: This report may be looked at from a high-risk perspective and a recommendation is provided for a short duration. This report is solely based on technical parameters, and the fundamental performance of the stocks has not been considered in the decision-making process. Other factors which could impact the stock prices include market risks, regulatory risks, interest rates risks, currency risks, social and political instability risks etc. 

Note 1: Past performance is not a reliable indicator of future performance.

Note 2: The reference date for all price data, currency, technical indicators, support, and resistance level is February 09,2026. The reference data in this report has been partly sourced from REFINITIV.

Note 3: Investment decisions should be made depending on an individual's appetite for upside potential, risks, holding duration, and any previous holdings. An 'Exit' from the stock can be considered if the Target Price mentioned as per the Valuation and or the technical levels provided has been achieved and is subject to the factors discussed above.

Note 4: Target Price refers to a price level that the stock is expected to reach as per the relative valuation method and or technical analysis taking into consideration both short-term and long-term scenarios.

Note 5: ‘Kalkine reports are prepared based on the stock prices captured either from the New York Stock Exchange (NYSE), NASDAQ Capital Markets (NASDAQ), and or REFINITIV. Typically, all sources (NYSE, NASDAQ, or REFINITIV) may reflect stock prices with a delay which could be a lag of 15-20 minutes. There can be no assurance that future results or events will be consistent with the information provided in the report. The information is subject to change without any prior notice.