Oscar Health

Premium rates are set through state filings and constrained by MLR minimums and competition. 2025 market morbidity and higher risk adjustment payable drove the Q2 MLR to 91.1 percent and forced a reset of 2026 filings that management expects to be double-digit. That underscores limited pricing power independent of the market.

Long term, earnings are governed more by risk selection, medical cost management, PBM terms and administrative efficiency than by discretionary pricing.