Oscar Health, Inc. is expanding its individual market footprint ahead of the 2027 plan year, adding 33 counties in Ohio and launching for the first time in South Carolina as the company builds out access to its CHOICE Arrangement employer funding model alongside its consumer plans.
The Ohio expansion brings Oscar to 73 of the state’s 88 counties on the ACA individual marketplace, adding markets in the Akron, Canton, Toledo, and Youngstown areas that were previously outside the insurer’s service area. Oscar has operated in Ohio since 2018, with its original footprint concentrated in the Columbus, Cleveland, and Cincinnati markets.
The South Carolina launch covers six counties: Charleston, Colleton, Florence, Horry, Marion, and York, according to the announcement.
Both announcements take effect for the 2027 open enrollment period, which opened November 1, 2026, with coverage starting January 1, 2027.
The plans available across both states include Oscar’s standard Bronze, Silver, and Gold tiers, alongside a growing suite of condition-focused and life-stage products. RetireEase, introduced for the 2027 plan year, is designed for individuals in early retirement who are not yet Medicare-eligible, offering set prices on key care services and access to generic medications at no cost. HelloMeno, first offered by Oscar for the 2026 plan year in partnership with Elektra Health, a virtual menopause care provider, is available in South Carolina and includes no-cost gynecology, behavioral health, hormone replacement therapy, and bone density screenings.
Condition-focused plans covering diabetes, COPD, asthma, and cardiovascular-kidney-metabolic syndrome are available in both states, with the company citing savings of 15% to 25% against a standard ACA plan with a cost-sharing reduction at the 150% federal poverty level benchmark.
Also available in Ohio through the expansion is Oscar’s CHOICE Arrangement offering, the rebranded version of what the federal government previously called an individual coverage health reimbursement arrangement (ICHRA). Under the CHOICE model, employers set a defined monthly contribution that employees use to purchase individual market coverage. Employers can enroll through Oscar’s platform or through their broker.
Oscar’s geographic expansion is partly a bet on ICHRA adoption continuing to accelerate. The company grew ICHRA membership in 2025 and 2026 across existing markets including Arizona, Florida, New Jersey, and Texas, with its Q4 2025 earnings call noting that ICHRA membership doubled year over year. Oscar’s overall paid membership reached approximately 2.9 million as of June 30, a 46% increase from the same period in 2025, according to the company’s second-quarter 2026 results.
That growth comes in a contracting overall ACA market. Total ACA marketplace membership declined approximately 12% year over year to 19.2 million as of mid-2026, following the expiration of enhanced premium tax credits at the end of 2025.
Oscar grew its share within that declining market. Its membership of approximately 2.96 million gave it roughly 15% of the 19.2 million total ACA enrollees as of mid-2026, up from approximately 11% a year earlier, based on publicly reported membership and CMS enrollment figures. The Ohio and South Carolina expansions are part of a stated plan to add between 400 and 600 counties by 2029, according to Oscar’s investor day presentation.
The CHOICE/ICHRA market sits at the intersection of these dynamics. As small employers weigh dropping or restructuring group health coverage under the pressure of rising premiums, CHOICE Arrangements give advisors a defined-contribution alternative that keeps employers in the benefits market without the renewal volatility of group plans. ICHRA adoption among small employers has grown sharply in recent years, with more than two-thirds of small businesses offering CHOICE Arrangements in 2026 reported to have not previously provided any health benefits to employees.
The plan designs, particularly the condition-focused tiers, are structured to address the high-utilization populations that often drive group premium increases.
The risk that ICHRA structures shift onto employees remains a live concern. Under a defined-contribution model, the employer’s cost is fixed but the employee’s coverage adequacy depends on what individual market plans are available in their county and whether the employer contribution is sufficient to make coverage affordable under federal affordability standards. As Oscar’s footprint grows, so does the number of markets where that calculation becomes possible to make.
