Oscar Health Expands to South Carolina and Adds Ohio Counties
Oscar Health, Inc. is growing its presence on the Affordable Care Act (ACA) individual marketplace for the 2027 plan year, entering South Carolina for the first time and adding 33 counties in Ohio. The move brings the insurer's Ohio coverage to 73 out of 88 counties, reaching new markets in Akron, Canton, Toledo, and Youngstown. Oscar has operated in Ohio since 2018, previously focusing on Columbus, Cleveland, and Cincinnati. The South Carolina debut targets six counties: Charleston, Colleton, Florence, Horry, Marion, and York. Both expansions take effect for open enrollment starting November 1, 2026, with plan coverage beginning January 1, 2027.
Along with standard Bronze, Silver, and Gold plan tiers, Oscar is introducing specialized offerings in these markets. The 2027 lineup features RetireEase, tailored for early retirees not yet eligible for Medicare, providing fixed prices on key care services and generic medications at no cost. South Carolina enrollees will also have access to HelloMeno, a menopause care plan launched for 2026 alongside Elektra Health that covers gynecology, behavioral health, hormone replacement therapy, and bone density screenings without cost sharing. Condition-specific options for diabetes, COPD, asthma, and cardiovascular-kidney-metabolic syndrome will be available across both states, providing 15% to 25% savings compared to standard benchmark plans at the 150% federal poverty level.
The expansion also delivers Oscar's CHOICE Arrangement platform to Ohio employers. Rebranding the federal Individual Coverage Health Reimbursement Arrangement (ICHRA) framework, the CHOICE model allows businesses to set a fixed monthly financial contribution for workers to purchase individual plans directly or via brokers. Oscar is leveraging this platform following a doubling of its ICHRA membership year over year as reported in its Q4 2025 earnings call, with growth spanning states like Arizona, Florida, New Jersey, and Texas.
Oscar's strategy unfolds against a shrinking broader ACA market, which dropped 12% to 19.2 million members by mid-2026 after enhanced premium tax credits expired at the end of 2025. Despite the market contraction, Oscar expanded its paid membership to roughly 2.9 million by June 30, 2026, a 46% year-over-year increase. This raised Oscar's share of total ACA enrollees from approximately 11% to 15% mid-2026. The new state entries support Oscar's larger goal of adding 400 to 600 counties to its service footprint by 2029.
Insurance professionals and industry stakeholders should observe how Oscar's expanding footprint alters individual and small group market dynamics. The growth of employer-funded defined contribution models like CHOICE offers small businesses an alternative to traditional group plans, but market participants must monitor whether fixed employer contributions remain adequate to keep individual coverage affordable for workers.
Why it matters
Oscar Health's expansion into South Carolina and additional Ohio counties highlights growing carrier investment in the individual market and defined-contribution ICHRA models despite overall ACA contraction.
FAQ
Which South Carolina counties is Oscar Health entering for 2027?
Oscar Health is launching in six South Carolina counties: Charleston, Colleton, Florence, Horry, Marion, and York.
What is Oscar's CHOICE Arrangement?
CHOICE Arrangement is Oscar's rebranded version of an individual coverage health reimbursement arrangement (ICHRA), allowing employers to provide employees with a defined monthly contribution to buy individual market health coverage.
How much did Oscar Health's paid membership grow by mid-2026?
Oscar's paid membership reached approximately 2.9 million as of June 30, 2026, representing a 46% increase from the same period in 2025.
Source: Insurance Business America. See the original source for full details.
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