Oscar Health said it will sell health insurance in six new markets, an aggressive expansion for 2019 despite continued regulatory and political assault on individual markets by the Donald Trump administration and Republicans in Congress.
The New York startup, which has made a big bet on offering individual coverage under the Affordable Care Act, has expanded Obamacare offerings this year to more states. That expansion into new markets paid off, with the insurer enrolling more than 250,000 in individual products under the ACA for this year.
Now Oscar has filed to offer insurance in nine states and 14 markets in 2019, “nearly doubling” its current footprint . The expansion is possible thanks to growth, improving financial operations and new funding announced earlier this year.
“Our six new markets will be spread across three new states — Florida, Arizona, and Michigan — and three additional large metro areas in Ohio, Tennessee, and Texas,” Oscar CEO and co-founder Mario Schlosser said in announcing the expansion. Oscar’s other co-founder is Josh Kushner, the brother of President Trump’s son-in-law, Jared.
The expansions come despite repeated and ongoing attempts by the Republican-led Congress and Donald Trump White House to end subsidies for individual customers, destabilize the market with unpredictable and 11th-hour regulatory changes and verbally trash the ACA’s individual coverage.
“In health care, 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 said. “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. In the six years since Oscar first launched, we’ve witnessed multiple legal challenges to the ACA, hundreds of attempts to replace it, and regulatory changes in the 11th hour.”
Oscar is expanding at a time larger players like Aetna, Anthem, Humana and UnitedHealth Group have either left or scaled back their Obamacare and related individual health insurance businesses. The larger players are scaling back or leaving the individual business after being unable to successfully manage the costs of sick patients signing up for coverage.
But Oscar said it’s expanding because its product has been popular with consumers and its members have therefore been engaged to get the right medical care, in the right place and at the right time.
“Each new member and interaction with the health care system offers Oscar an opportunity to refine our member apps and make better recommendations for care; to enable our population health leads and Concierge teams to drive more personalized interventions; to empower providers with easier tools that let them focus on delivering care,” Schlosser said. “That’s because Oscar built and owns the full insurance stack, from our claims system to our mobile apps, allowing us to constantly feed structured data back into system and fuel the member experience.”
Oscar has also established some notable relationships with medical care providers in the markets it has entered. This year, for example, Oscar began to offer co-branded individual insurance in Ohio with the Cleveland Clinic in five northeastern counties in that state.
Oscar's other new markets for this year include Nashville, Tennessee, and Austin, Texas, where it has individual products already in San Antonio. Oscar also returned to New Jersey to sell individual health plans on public exchanges under the ACA. Oscar has been in New York and the California markets of Los Angeles, Orange County and San Francisco.
“The confidence that stems from building a health care experience that consumers demand has served us well and will continue to do so in the future -- indeed, even as we announce new individual markets today, just three weeks ago we began enrolling small businesses for Oscar plans in Los Angeles,” Schlosser said. “In 2019, there will be yet more noise. But Oscar will still be here, stronger than before, in more cities than before, focused and inspired by the mission of better health care for our members.”