Oscar Health to sell Obamacare plans in 6 new markets next year

Technology-focused insurer Oscar Health on Thursday said it will sell individual health plans on the Affordable Care Act exchanges in three new states and several new metropolitan areas in 2019.

New York-based Oscar is bringing its narrow-network exchange plans to Florida, Arizona and Michigan, as well as new metro areas in three states where it already offers insurance, including Ohio, Tennessee and Texas.

In total, Oscar has filed to sell individual exchange plans in nine states next year, up from six in 2018 and three in 2017.

"Our sustained expansion positions Oscar as one of the fastest-growing individual market insurers in the country, and speaks to the power and effectiveness of our unique playbook," Oscar CEO Mario Schlosser said in a blog post published Thursday.

While other health insurers have retreated from the ACA exchanges because of financial losses and ongoing instability in the market, Oscar has aggressively snapped up market share and grown enrollment. It covers about 240,000 individual members this year, up from 100,000 in 2017.

The insurer, which describes itself as a consumer-facing plan with an emphasis on technology and virtual care, has struggled with high administrative costs and inefficient processes. But it is betting its strategy of creating narrow networks through partnerships with major health systems will draw membership and prove profitable despite so much uncertainty over the future stability of the exchanges.

Oscar paired up with Cleveland Clinic in Ohio and Tenet Healthcare Corp. in Dallas, for example. By partnering, the hospitals see more patients and Oscar enrolls more members who want access to those healthcare systems.

"In healthcare, legal, political and regulatory uncertainties are a fact of business, but Oscar has remained focused on our long-term vision for a simpler, easier, and more affordable system," Schlosser wrote, noting the many attempts to repeal the ACA and the last-minute regulatory changes. "This kind of relentless focus on building what consumers want means that Oscar can withstand and adapt to new environments—both as we scale deeper into the individual market and begin to grow beyond it."

Oscar recorded its first quarterly profit in the first quarter of 2018, signaling its so-called playbook could be paying off.

Oscar's expansion into new states isn't a surprise. Schlosser has previously said the company would grow by a few new cities each year. This year, it sells coverage in cities in California, Ohio, New Jersey, New York, Tennessee and Texas.

Oscar did not disclose what its 2019 premiums would look like, but so far initial rate requests in states that have released them have varied widely by location and insurer, and many are asking for double-digit rate hikes. The loss of the individual insurance mandate and the potential influx of skimpier, cheaper health plans are driving the premium increases.