Oscar pulls out of ACA exchanges in New Jersey & Dallas; expanding into San Francisco

Thanks again to commenter "M E" for finding this Business Insider article in which health insurance startup Oscar Insurance Co. has announced that they're pulling out of the ACA exchange completely in New Jersey, and out of the Dallas market specifically in Texas...while also expanding into San Francisco next year:

According to a release from the company on Tuesday, the firm will no longer offer individual market plans through the Affordable Care Act in Dallas, Texas, and New Jersey.

..."We hope to return to these markets as we carry on with our mission to change healthcare in the US."

The "we hope to return" part suggests that Oscar will continue to be available off the exchange in New Jersey, since completely pulling out of a state means a carrier has to wait at least 5 years before re-entering. So...there's that, anyway.

...Oscar currently covers 7,000 people in Dallas and 26,000 in New Jersey.

Hmmm...26K is slightly higher than the 24.6K I had entered for New Jersey in my 2017 rate hike estimate, but it's pretty close. As "M E" noted, in NJ this actually has the ironic effect of lowering the average requested rate hike, since Oscar's 10.6% was slightly higher than the original 8.7% average. That's small comfort to those 26,000 people, of course:


As for Texas, that's a little trickier for two reasons: First, according to Data.Healthcare.Gov, Oscar currently participates in 4 counties total: Bexar (which includes San Antonio), Collin, Dallas and Tarrant. It sounds like they're sticking around in the other 3. 7,000 people is for Dallas only...how about the others? Well, Dallas County has 2.48 million people. Bexar is 1.818 million; 855K for Collin and 1.912 million for Tarrant. Dallas Cty is around 35% of the total. Assuming Oscar's enrollment is proportional in each (it probably isn't, but it's all I have to work with here), that would mean Oscar has roughly 20,000 enrollees state-wide, of which 7,000 are impacted.

UPDATE: Arrrgh...ok, never mind; it turns out they had around 34.7K statewide as of June. That leaves around 27.7K still enrolled in renewing counties.

Until now I was operating on the assumption that Oscar has closer to 90,000 enrollees in Texas, so the next impact of Oscar pulling out of Dallas and Scott & White dropping out (around 4,700 enrollees) bumps the statewide average up a few points, from around 35% to 37.8%.

Unlike Aetna, UnitedHealthcare and Humana, each of which is only reducing their coverage areas, it's not all bad news from Oscar:

...The company said it still plans to expand its offerings to the San Francisco market in 2017. The firm also will continue to offer coverage in New York, San Antonio, Los Angeles, and Orange County, California.