OSCRNYSEThe short version
Oscar Health, Inc.
Oscar Health sells subsidised individual health plans on the ACA marketplaces in 20 US states. The federal government funds 93% of the premium; Oscar pays its members' medical claims out of what it collects.
Listed at $34.80 in March 2021, down to $2.15 by December 2022, back to $23.27 on 19 September 2024, halved again to $10.85 on 30 March 2026, then up 161% to $28.34 in eighty-two sessions.
Mkt cap $816.6MNet cash $4.4BEV −$3.6BP/E FY27E 18.7×
$28.34
Share price, 27 Jul 2026
$8.48B
Market cap, filed share count
6.07%
Adj. FCF yield, 3-yr average
93%
Of premiums paid by CMS
SwipeScroll▾
Snapshot
Oscar Health, Inc. in numbers
Price
$28.34as of 2026-07-27
Mkt cap
$816.6M
Net cash
$4.4B
EV
−$3.6B
12m perf
+93.2%
3m ADV
$176.1M
| Year to Dec (USD) | 2023 | 2024 | 2025 | 2026E | 2027E | 2028E |
|---|---|---|---|---|---|---|
| Sales | 21.4M | 20.6M | 28.6M | 18.5B | 19.8B | 22.2B |
| EBITDA | −204.9M | 89.4M | −367.5M | 525.8M | 725.9M | 1.0B |
| EBIT | −235.6M | 57.3M | −396.4M | 428.4M | 632.0M | 913.1M |
| EBIT margin | −1103.4% | 278.3% | −1386.2% | 2.3% | 3.2% | 4.1% |
| EPS | −1.22 | 0.10 | −1.69 | 1.10 | 1.51 | 2.21 |
| EV/EBITDA | n/a | −39.8× | n/a | −6.8× | −4.9× | −3.5× |
| EV/EBIT | n/a | −62.1× | n/a | −8.3× | −5.6× | −3.9× |
| P/E | n/a | 283.4× | n/a | 25.8× | 18.7× | 12.8× |
| FCF yield | – | – | – | 420.7% | 54.0% | 205.5% |
| Gearing | −195.5% | −121.1% | −239.8% | – | – | – |
Consensus: S&P Capital IQ (CapIQ) · as of 2026-07-28Derived from run data; ratios use the latest price.
IThe business
What it sells
Oscar sells subsidised individual health plans, and Washington pays 93% of the premium
FY2025 revenue by source
Insurance premium$11,469.9M98%
Investment income$202.9M2%
Platform, brokerage and other$28.6M0%
Total revenue $11,701.4m, reported as one segment.
- One product. ACA marketplace plans in 20 states, sold in the five metal tiers. Premium is 98.0% of FY2025 revenue; the +Oscar platform and the 2025 brokerage acquisitions together are 0.24%.
- One payer. 93% of premiums are earned directly from CMS and 7% from members, and roughly 97% of 2025 direct policy premiums were subsidised. The enhanced credits expired at the end of 2025.
- Concentrated, and re-elected yearly. Florida holds 57.8% of the 2.04m members at 31 December 2025 and three states carry 86.0% of the book; every carrier elects each state market annually.
Where the profit sits
Revenue has compounded 59% a year; operating profit has arrived once in five years
Earnings from operations, FY2021-FY2026 ($M)
FY2026 is the $250-450m guidance midpoint.
- Scale came first. Revenue went from $1.84bn in FY2021 to $11.70bn in FY2025, with $18.7-19.0bn guided for FY2026 — a 61% step at the midpoint.
- Margin is the variable. The medical loss ratio rose 570 basis points to 87.4% in FY2025, turning $250m of guided operating earnings into a $396.4m loss.
- The year is front-loaded. Members meet deductibles as the policy year runs, shifting claims into the second half, so Q1 2026's $704m of operating earnings is a seasonal shape, not a run rate.
IIIThe story now
The fit
Outside the framework's universe (U2 not met); contested: P4a
$8.48B
Market cap vs the $10bn universe line15.2% short
0.385
Year-10 durability probability (P1)
−243bps
3-yr adj. FCF yield vs the 8.5% line
0.71
Probability the damage is temporary (P5)
Confidence high: two model families agreed, spreads at most 0.15.
- The screen is size, not quality. The 299.1m shares filed at 31 March 2026 at the $28.34 close give $8,477.7m, 15.2% under the line. The widest count in the record, 329.8m diluted, still reaches only $9,345.2m.
- The strongest counter-fact. The run's own feature file understates the company by roughly $1.0bn by using a weighted-average basic count; correcting it narrows the gap from 25.6% to 15.2%. No convention clears the line.
- The rest of the ledger. No exclusion hit and no China flag; the dated event, capitulation, forward path and diagnosis are met; the year-10 gate, FCF consistency, yield-versus-bar and repurchase engine are not.
P4a — whether Oscar can outlast the problem with allocation headroom intact — is the run's one contested criterion, split two to two along model families.
The dislocation
The fall was real: 53% over 557 days, on volume 15 times normal
Peak, trough and the 27 July 2026 close.
- Two dated triggers. Centene's 1 July 2025 disclosure of market-wide morbidity took Oscar down 18.7% the next day on 78.0m shares, 29.1 times normal; the enhanced premium tax credits then lapsed at the end of 2025.
- Fear was priced in July 2025. The 20-day average volume peaked at 41.5m shares against a 2.68m pre-shock median — 15.5 times, against a 2x reference line — and short interest reached 34.7% of float.
- The counter-fact. That spike closed on 29 July 2025 at $13.84, already 40.5% below the peak, and the price fell a further 21.6% over eight months to $10.85 on ordinary volume. Peak fear did not mark the low.
Damage math
A $646m earnings hit against $2.0bn to $2.7bn of value taken out at the trough
Value per share: damage estimated vs damage priced
Pre-event close, 19 Sep 2024
$23.3
Temporary scenario
$21.5
Weighted at 0.71
$20.0
Permanent scenario
$16.3
Trough close, 30 Mar 2026
$10.8
Two-scenario discounted model at 12%, on 299.1m shares.
- 85% of it is one line. Risk-adjustment transfers stepped from 14.52% to 18.45% of direct and assumed premiums — $552.5m of the $646.4m swing. Volume never broke: the same revision raised revenue guidance $850m.
- The gap was there. At $10.85 the price had destroyed $12.42 a share against $3.28 to $5.72 of probability-weighted damage: a gap of $2,004m to $2,733m, 38% to 46% of the weighted value.
- And it has closed. At $28.34 the price sits 41.8% above the weighted $19.99 and just under the $29.57 the same model returns when management's 5% margin target is met on the 2028 revenue base.
Temporary or permanent
Three blind judges put the odds the damage is temporary at 0.71
Risk-adjustment transfers, share of direct premiums
The 2025 step is the event; 2026 is management's own assumption.
- A margin event on an intact base. Revenue grew 28% to $11.7bn in the year of the loss and is guided up 61% for 2026; Oscar refiled 2026 rates at about 28% in states covering 99% of membership.
- The level does not revert. Management assumes about 20% of direct premiums for 2026, above 2025's 18.5% and well above 2024's 14.5%. What corrects is the pricing for it, not the transfer itself.
- The counter-fact. Q1 2026 accrued risk adjustment at 24-24.5% against that 20% assumption and carried $68m of favourable prior-period development; consensus expects the back half to spend the profit down.
Year-10 durability
The framework's one binary gate reads 0.385: the doubt is the subsidy, not the demand
Where year-10 conviction would have to come from
| Conviction source | What the record shows |
|---|---|
| Market structure | Footprint share moved 17% to 30% in one year |
| Regulatory barrier | Blocks startups, not incumbent carriers re-entering |
| Capital intensity | Property and software $94.2m — 1.0% of assets |
| Essential product | Coverage yes; the subsidy that buys it is policy |
| Operating history | 14 years, one profitable, $3,294.4m deficit |
P1 is binary by construction: proper doubt resolves downward.
- What the reading rests on. About 98% of revenue sits inside one federal statute, 93% of premiums arrive from one payer, and every carrier re-elects its state footprint each year.
- The deciding arithmetic. Scaling the $18.85bn FY2026 guidance midpoint back to the 2025 footprint share of 17% gives $10.68bn — below FY2025 actual revenue, with no operating failure at Oscar required.
- The counter-fact. Oscar grew straight through the shock: 3.2m members at 31 March 2026, up 56%, while the market contracted about 5% — 24m lives to 23m — against management's own 20-30% assumption.
Self-help
No share has ever been repurchased, and the count is up 18.8% in a year
None
Shares repurchased since the 2021 listing
+18.8%
Shares outstanding, 2024 to 2025250.5m to 297.7m
8.8 yrs
Adjusted FCF to retire the floatthe reference is about 3
$0
Dividends ever paid
Item 5 of the FY2025 Form 10-K reports issuer purchases as "None".
- The flywheel is absent. No repurchase line appears in FY2023-FY2025 financing activities, no authorisation exists in any 10-K since listing, and repurchases are not raised once across twelve earnings calls.
- The count moved the other way. 250.5m shares outstanding at end-2024 became 297.7m a year later, 33.1m of it fourth-quarter conversion of $270.0m of notes at about $8.32.
- The counter-fact. The company is not indifferent to dilution: it paid $34.4m for capped calls in September 2025, capped at $37.46. That manages dilution rather than retiring stock.
The February 2026 secured revolver separately restricts repurchases of equity interests while it is in place.
IVThe price
Yield versus the bar
Adjusted cash yield sits 243 bps under the framework's fortress line
Adjusted FCF yield by basis vs the 8.5% line
FY2025 reported
13.1%
FY2024-FY2025 average
12.2%
Mid-cycle normalised
7.9%
3-year average
6.1%
5-year average
3.5%
Adjusted FCF = operating cash flow less capex less stock compensation.
- The 13.06% is float, not earnings. The CMS risk-adjustment payable rose $1,029.4m in FY2025, 106% of the $970.8m numerator, while the company lost $443.2m; strip working capital and it is −$488.2m.
- Where it sits. The three-year average of 6.07% is 243 bps short of the line a net-cash balance sheet selects; normalised at a 3.5% mid-cycle margin, adjusted FCF is $586.3m and the yield 7.88% — 62 bps short.
- The counter-fact. The window decides it. The adjacent FY2024-FY2025 average is 12.18%, above the line; the three-year window is dominated by FY2023, when adjusted FCF was −$457.4m at half today's revenue.
The re-rating math
At the framework's own line, normalised cash flow supports $23.06 a share
What each basis is worth per share
| Basis | Per share |
|---|---|
| 8.5% line on mid-cycle adjusted FCF | $23.06 |
| Permanent scenario | $16.29 |
| Probability-weighted at 0.71 | $19.99 |
| Pre-event plan achieved, 5% margin | $29.57 |
| Consensus target, mean of ten | $24.20 |
| Close, 27 July 2026 | $28.34 |
The deterministic re-rating math is unavailable; this is rebuilt from the surviving claims.
- The bar sits below the price. Mid-cycle adjusted FCF of $586.3m at 8.5% supports $6,898m of value — $23.06 a share on the 299.1m shares filed, 18.6% below the 27 July close.
- What a treble would take. $85.02 a share is $25,433m of market value, which needs $2,162m of normalised adjusted FCF: 3.7 times the mid-cycle figure and 9.7% of the FY2028 consensus revenue base against the 3.3% consensus implies.
- The counter-fact. The distance to the yield bar itself is small — about $109m more 2028 cash flow, implying roughly a 4.6% operating margin against consensus's 4.11% and management's approximately 5% target.
The clock
The re-recognition this pattern usually waits years for arrived in 43 days
Consensus normalised EPS by estimate vintage ($)
Vintages dated 28 January, 28 April, 27 June and 27 July 2026.
- Prior episodes took months to years. Four earlier drawdowns of 50% or deeper took 166 to 1,772 days to regain their prior peak; this one took 43 days from the March 2026 trough, six days after the Q1 print.
- Consensus followed the price. FY2028 estimates doubled from $1.08 to $2.21 between January and July 2026 while the shares rose 91%; the mean target of $24.20 now sits 14.6% below the close.
- What is still on the calendar. Q2 results on 6 August 2026 carry the first claims-based read on 2026 morbidity, the 2027 rate filings land in the second half, and open enrollment now closes 15 December.
Instrument context is recorded as not verifiable: the option-chain and implied-volatility facts come from dated web sources with no corpus page behind them.
What to watch
A real forecasting-error dislocation, already repriced — on a company under the framework's size line
- 01FY2026 actual operating income below $250M or full-year MLR above the 83.4% guide ceiling after the Q1 beat.
- 02Risk-adjustment accruals materially above the approximately 20% direct-premium assumption or another Q4 true-up above $100M.
- 03Paid membership below roughly 2.6M by year-end 2026 despite repriced plans.
- 04A second consecutive year of double-digit corrective 2027 rate filings driven by morbidity or risk-adjustment misses.
This distills a fixed five-pillar fit test, built tab by tab; the full report carries the workings, the sources and every counter-fact.
Compiled from the full report · 2026-07-28 · For information, not investment advice.