The individual market is the future of health insurance: Takeaways from the Axios Future of Health Summit

At the Axios Future of Health Summit, Oscar Health CEO Mark Bertolini made a clear case: the individual market is the insurance marketplace of the future for consumers and businesses. The market is lowering the cost of healthcare and driving competition, quality, and choice. Investing in it is key to helping more consumers choose their own healthcare and giving more employers the freedom to grow their businesses.

For a country long tethered to employer-sponsored coverage, that is a bold claim. But Bertolini’s argument is grounded in both the individual market’s clear success and evolving consumer needs and expectations. The individual market, as he explained, is not just working—it is outperforming the existing model. Here are three of the biggest takeaways from the conversation.

It's time to build on the proven success of the individual market

While employer-sponsored coverage continues to see rising premiums and fragmented experiences, the individual market has quietly achieved something unexpected to many: cost control. During the conversation, Bertolini cited the individual market premium price trends over the past few years, which are below that of the Consumer Price Index.

That is not surprising. By design, the individual market’s risk-adjustment system balances financial performance across insurers. At the end of each year, those insurers that outperform the broader market contribute to a shared pool, while those that fall short receive support. That redistribution mechanism helps stabilize pricing—especially for people with chronic conditions—and discourages plans from cherry-picking members.

The proven stability of the individual market means that it is time to double down on the model. “The total individual market could eventually hold around 120 million lives. That scale would make risk even more stable and drive costs down,” Bertolini said. “The time is coming."

ICHRA is the logical next step for the defined contribution model

Employers today, especially small ones, are facing a tough reality: double-digit rate increases, broad networks with high price tags, and limited ways to personalize coverage for their evolving, diverse workforces.

Bertolini offered a better path forward: the Individual Coverage Health Reimbursement Arrangement. Better known as ICHRA, it allows employers to give employees tax-free dollars to purchase health coverage on the individual exchange. For employees, that means more control, more plan portability, and better alignment with their specific health needs. For employers, it offers budget predictability and reduces administrative burden.

A defined contribution model built on flexibility, choice, and portability is not a new idea. “We did it with pensions,” Bertolini said, referring to the 1978 creation of the 401(k). “Now the time has come to do it with health insurance.”

The individual market has a bipartisan foundation

In today’s political landscape, it is hard to find issues where policymakers see eye to eye. The individual market has become one of those rare issues.

The Affordable Care Act, which was designed by Democrats, laid the groundwork by expanding access to care and establishing broad protections for consumers. Years later, the Trump administration created ICHRA. Together, the ACA and ICHRA are creating a bipartisan framework that supports the healthcare goals of both parties: more access, more choice, and more affordability.

The alignment comes at a critical time. Bertolini noted during the session that in 2024, Americans borrowed $74.9 billion to pay off their medical bills. This is unsustainable trend that demands fast solutions.

“This idea of creating a stable, larger market where people can shop, protect their finances, and avoid borrowing is long overdue,” said Bertolini.

Ready to see how the Individual Market works? Learn how Oscar’s ICHRA solutions give employers and employees more choice, control, and portability.