What Oscar Health, Inc. told the SEC could break it.

Oscar Health is almost entirely dependent on a single policy regime and a single payer. For 2025 and 2024, approximately 98% of revenue was derived from health plans regulated under the Affordable Care Act, and about 93% of premiums were collected directly from the Centers for Medicare & Medicaid Services (CMS) through the Advanced Premium Tax Credit (APTC) program. Any repeal of or material change to the ACA and its regulations, or expiration/reduction of the enhanced APTC subsidies, would directly and severely affect Oscar's membership, premiums, revenue and financial condition. This concentrates both regulatory/political risk and counterparty (CMS) risk in one place, making Oscar unusually sensitive to federal health-policy shifts.

“For each of the years ended December 31, 2025 and 2024, approximately 98% of our revenue was derived from sales of health plans subject to regulation under the ACA, primarily comprised of policies directly purchased by individuals and families.”

Oscar's members obtain healthcare services from a limited number of providers with whom it contracts, concentrating its medical-cost base. In FY2024, AdventHealth, HCA Healthcare and University of Miami Hospital & Medical Group accounted for approximately 10%, 8% and 7% of total allowable medical costs, respectively, and in FY2025 a small group of South Florida providers again represented roughly 9%/8%/7%. A contract dispute, network termination, or material rate increase from a key provider system could raise Oscar's medical costs, disrupt member care and narrow its network in important markets such as South Florida.

“substantially all of our revenue depends on the direct policy premiums we collect from members or from the federal government on behalf of our members who obtain healthcare services from a limited number of providers with whom we contract.”