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Wednesday, Aug 24 2016

Full Issue

Insurance Startup Oscar Pulling Out Of Health Law Marketplaces In N.J. and Texas

The company says it has suffered significant losses on the Obamacare markets and is rethinking its approach.

Health insurance startup Oscar Insurance Corp. will reevaluate its approach to Obamacare after suffering significant losses under the U.S. program and will pull out of two markets next year. Oscar, which pitches itself as a tech-savvy alternative to traditional health insurers, plans to end sales of Affordable Care Act plans in Dallas, a market it entered this year, and New Jersey. It鈥檚 part of a more conservative approach by the New York-based company as it plans to introduce insurance products for businesses next year. (Tracer, 8/23)

A health insurance startup that was one of Governor Charlie Baker鈥檚 favorites in his venture capital days will pull out of two markets after losing money under Obamacare. ... Oscar has become a darling not only of Baker, a health care policy wonk who used to run Harvard Pilgrim Health Care, but of numerous investment firms. Boston-based Fidelity in February led a $400 million round of funding that raised the company鈥檚 valuation to $2.7 billion. (Healy, 8/24)

The roughly 1.3 million Texans who bought health insurance under the Affordable Care Act will likely have fewer, more expensive coverage options in 2017, as health plans continue to announce they will no longer sell their products in Texas. Insurance start-up Oscar announced on Tuesday it would pull out of the Texas market, joining veteran health plans Aetna, UnitedHealthcare and Scott and White on the list of companies that recently announced they would abandon the marketplace created by President Obama鈥檚 signature health law. The companies said their costs of providing coverage to middle-income Texans have been unsustainable, fueling concerns about a lack of competition and consumer choice within the health insurance market next year. (Walters, 8/24)

Oscar launched in New York in 2013 and expanded to Texas in 2016 with plans offered in Bexar, Collin, Dallas and Tarrant counties. The company insures about 7,000 people in Dallas. The post from Schlosser on Tuesday said 鈥渦ncertainties鈥 in the Dallas-Fort Worth market make it challenging to operate effectively. ... Blue Cross Blue Shield of Texas says it has not made a decision about whether or not it will remain in the Obamacare marketplace in 2017. In May, it asked to increase the rate for individual plans it sells on the exchange market by and average of nearly 60 percent. (Rice, 8/23)

Big insurers like Aetna, Humana and UnitedHealthcare aren鈥檛 the only ones why say they鈥檙e struggling to make a profit on the public exchanges set up under the Affordable Care Act. Oscar Insurance Corp., a startup created specifically to cater to customers on the Obamacare exchanges, has also seen significant losses, prompting the young company to pull out of two markets next year, Bloomberg reports. (Braverman, 8/23)

Oscar鈥檚聽announcement comes a week after Aetna became the third major insurer to announce it would withdraw from some exchanges in 2017, prompting questions about what聽steps may be necessary to聽stabilize the exchanges. The company will enter the San Francisco market, and will continue to offer聽plans in the聽New York, San Antonio, Los Angeles and Orange County markets, [CEO Mario Schlosser] said. The company is also聽poised to begin providing small group insurance coverage聽in some markets next year. (McIntire, 8/23)

Health insurance startup Oscar is pulling out of two ObamaCare markets next year, saying like large insurers that the company is having trouble making money. Oscar has been closely watched as a tech-savvy competitor that sought to make health insurance more consumer-friendly. (Sullivan, 8/23)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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