Oscar Health is building the new consumer health economy

Today we introduced Oscar Health’s new mission to give people more power over their healthcare. The vision is simple: Make the individual market the foundation for a healthcare system built around people.

At its Investor Day in New York City, leaders outlined how Oscar Health will advance this vision through two brands: Oscar Insurance, which designs health insurance around people’s lives, and Lucie Health Marketplace, a payer-agnostic technology platform that simplifies healthcare shopping. Each addresses different sides of a growing individual market: the coverage people use and the marketplace where they choose it.

Oscar Health’s long-term strategy centers on three objectives: (1) Unlock the full potential of the individual market to support all Americans; (2) Become the No. 1 consumer-preferred, tech-native carrier through its strategic ACA advantage; and (3) Build the leading health marketplace to serve people’s health and financial goals.

Unlocking the individual market’s full potential

The ACA is the fastest-growing, most competitive health insurance segment, growing at 9% CAGR from 2020 to 2026. The ACA provides the foundation for a market that can serve all Americans, where consumers drive greater innovation, efficiency and value.

Last year, 3.4 million people entered the ACA market, including gig workers, small-business owners and early retirees. As the employer benefit model begins to crack, CHOICE Arrangements (formerly ICHRA) are driving growth by allowing employers to fund coverage employees choose.

“Strong tailwinds will take the market to roughly 23 million lives by 2029, but at least 100 million Americans will benefit from a model that puts individual choice in focus,” Bertolini continued. “We built the scale, earnings, and technology to lead the ACA, expand it into a larger individual market, and create a health marketplace where consumers hold the power.”

In 2026 the ACA covers approximately 19 million people, and Oscar Health estimates the market will reach approximately 23 million by 2029 as CHOICE enrollment grows to 2.5 million lives, AI-driven workforce shifts accelerate, more gig workers enter the market, and the labor market evolves.

CFO Scott Blackley outlined the financial outlook. Oscar Health raised its 2026 earnings outlook by $100 million, and expects revenue of $18.7–$19 billion and earnings from operations of $600–$800 million in 2026. Looking further ahead, by 2029 Oscar Health is targeting compound annual revenue growth above 20%, an operating margin of 5%–7% and earnings per share above $4.

Beyond the core ACA market, approximately 28 million Americans remain uninsured, and CHOICE will expand individual coverage to 200 million part-time, gig and independent workers, as well as employees at businesses of every size. Over time, the market could extend to people served 100 million people through government programs.

Oscar Insurance: Becoming the No. 1 consumer-preferred, AI-native ACA carrier

Oscar Insurance President Janet Liang outlined a strategy to become the consumer’s first choice through disciplined growth, tailored networks for the ACA, and lifestyle product innovation.

Membership grew from approximately 1.6 million in June 2024 to roughly 3 million in June 2026. By 2029, Oscar plans to enter another 400 to 600 counties, expand its potential reach from 9.6 million to 16 million lives (up 65%), and capture more than 18% of the national ACA market.

Oscar’s CHOICE membership roughly doubled year over year, and the company is introducing more than 250 off-exchange products for 2027. By 2029, Oscar aims to nearly triple its CHOICE market share and capture approximately 20% of high-priority markets.

For Hispanic, Latino and Spanish-speaking consumers, Buena Salud provides a Spanish-first experience with culturally matched providers. HelloMeno supports Millennial and Gen X women through perimenopause and menopause care. For people with chronic conditions, Oscar offers coverage like Diabetes Care plans and Breathe Easy for COPD. For employers and workers using CHOICE, Hy-Vee Health with Oscar combines concierge care with savings on gas, groceries and food-as-medicine programs.

These products are supported by tailored local networks for the individual market. Rather than asking members to pay for the breadth of a large commercial network, Oscar builds each network around the doctors, health systems and specialists people value. Concentrating on high-value providers strengthens care pathways, referral patterns, and lowers unit and total medical costs. Oscar achieved a 210 bps unit cost reduction in 2024-2026E.

That network strategy also supports a more personalized member experience. Oscar combines member context with information about quality, price and referrals to guide people toward the right care and next step.

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Lucie Health Marketplace: Building America’s leading health marketplace

Choosing coverage can mean sorting through more than 100 medical plans, plus separate dental, vision and supplemental products – each with its own website, renewal cycle, provider network and approach to costs. More options can create confusion instead of control.

Lucie is an online retail destination for healthcare shopping. It gives people one place to compare ACA medical plans, dental, vision, and other supplemental products, so they can build coverage for themselves and their families. Today, Lucie connects consumers and brokers with coverage from more than 70 carriers, with continued plans for expansion. By 2029, Lucie could support approximately 2.6 million ACA and specialty policies and more than 28,000 active brokers. Lucie also plans to offer CHOICE services and marketplaces that employers, associations and platforms for gig and part-time workers can offer under their own brands.

Consumers can enter their doctors, prescriptions, budget and coverage priorities, and Lucie will identify suitable plans, confirm coverage, and support enrollment. For employers adopting CHOICE, Lucie helps employees select coverage for their needs. As a CMS-approved Enhanced Direct Enrollment platform, Lucie helps brokers narrow options to what’s most relevant to their client.

Oscar Health estimates Lucie’s potential market at approximately $650 billion across ACA and supplemental enrollment, CHOICE services and consumer health products. These higher-margin areas can create value beyond 2029.

“People can compare their options before making major decisions about their homes, cars and education,” Bertolini said. “Healthcare is different. For something that can represent a household’s largest expense, consumers are often handed a plan without a clear way to explore alternatives or add the protection they need. Lucie is creating one marketplace where people can shop, compare and put together coverage that works for them. It’s time consumers owned their healthcare decisions.”

The technology expertise fueling Oscar Health’s next chapter

Mario Schlosser, co-founder and advisor to the CEO, explained that Oscar Insurance was built on a full-stack health-plan platform that connects enrollment, billing, provider data, claims, clinical information, service and the member experience.

Building AI into these systems helps automate routine, high-volume work, freeing teams to focus on tasks that need human review. From 2024 through 2026, Oscar improved operating leverage by approximately 33% and generated more than $3 billion in total medical-cost savings through better member experiences, smarter care navigation, affordability programs, clinical decision support, automation and self-service. Examples include:

• Member service: Oswell resolves 30% to 40% of messages and calls.
  Oscar’s AI assistant answers member questions, completes routine tasks and checks response quality – giving Care Guides more time for complex cases requiring human judgment and empathy.
• Care management: Preparation reduced from 20 minutes to 5 minutes per call.
  AI summarizes medical records, giving care teams more time to listen, assess and help members.

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Oscar Health’s AI advantage is having the data and platform to identify where AI can improve speed, cost or experience – and where it cannot. This expertise will inform Lucie’s approach to give every household easy-to-use plan selection tools that help people make informed, confident decisions about their healthcare.

Click here to download and view Oscar Health’s Investor Day Fact Sheet