Oscar Health puts brakes on new ACA signups in Florida

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Health insurance company Oscar Health will temporarily stop accepting new members in the state of Florida beginning today, a move the company said was based on a strong Affordable Care Act Open Enrollment performance.

Current Oscar members in the state who are seeking plan renewal for 2023 will not be impacted. They can renew their ACA plan for 2023 throughout the remainder of open enrollment through the exchange or their broker.

Any new Oscar member in Florida that has enrolled for 2023 prior to Tuesday will also not be impacted. Oscar said it remains “steadfast” in the Florida market, and intends to continue to provide coverage throughout 2023 and beyond.

WHAT’S THE IMPACT

As disclosed in Oscar’s Q3 2022 Form 10-Q, the company proactively engaged regulators – as a result of the changing market dynamics following market exits by certain carriers – regarding options to manage its membership growth. 

Prior to open enrollment, the company requested that regulators limit its membership growth in Florida so that total membership across all markets would be within its previously announced target range of 1 million members, plus or minus 10%. 

This limit, Oscar said, would allow the company’s projected membership not to exceed the company’s targets for 2023 and “maintain its strong financial position.”

THE LARGER TREND

The move follows news last month that both Oscar and Bright Health are drawing back on their Medicare Advantage business. Oscar has exited its organic MA business in New York and in Texas, said CEO and founder Mario Schlosser.

“And (the) MA market is a market we want to eventually go back to do more in, but the way for us to be in this market is through partners,” Schlosser said. The strategic focus is on Affordable Care Act plans, he said.

“We at Oscar have lived two years where the markets were stable,” he added. “And even against the complex backdrops, we’ve been grinding out improved performance. Hence, we don’t grow tired of saying this, but the individualized ACA market looks to us much more like the future of a competitive U.S. healthcare system than any other health insurance markets.”
 

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