August 6, 2026

Oscar, Clover Have Good Financial Results

Exchange-dominant Oscar Health reported strong Q2 results, with a profit of $362 million compared with a loss of $228.4 million a year ago. The company saw record profitability in 1H 2026, generating $1.1 billion in earnings from operations and $1 billion in net income.

Clover Health’s Medicare Advantage (MA) membership grew 48% year-over-year in Q2 to 157,309 members. The company posted $153 million in profit, up 54% from Q2 2025, and revenue of $743 million, up 56% from Q2 2025. It was also buoyed by its Star lawsuit win.

Additional article: https://www.fiercehealthcare.com/finance/oscar-health-boosts-2026-earnings-outlook-after-record-profitability-during-first-half-year

#healthplans #margin

https://www.fiercehealthcare.com/finance/clover-health-reaffirms-ai-commitments-discusses-star-rating-amid-strong-q2-performance

Fitch Says Hospital May Peak

Ratings advisory Fitch says nonprofit hospitals have broadly maintained their steady operating performance improvements, but that 2026 could be a peak because of crushing policy changes that will remove revenue from providers. 

#obbba #medicaid #hospitals

https://www.fiercehealthcare.com/providers/fitch-2025-likely-brief-operational-peak-nonprofit-hospitals-ahead-obbba-changes

Small Group Costs To Spiral

Preliminary rates from throughout the country show that small business health insurance could see health costs rise markedly in 2027, with a median proposed premium increase of 14% reported.

#employercoverage

https://www.healthsystemtracker.org/brief/how-much-and-why-premiums-are-going-up-for-small-businesses-in-2027/

Health Affairs Bias

I am increasingly concerned by Health Affairs’ bias. It just published a Forefront blog attacking the Trump administration’s reference pricing reforms. Healthy debate is good, but Health Affairs did nothing to discuss the true relationships the authors had. It indicated the authors are full-time employees of the National Pharmaceutical Council, a non-profit health policy research organization, which submitted public comments on the GLOBE and GUARD models to CMS.

The reality: the National Pharmaceutical Council (NPC) is no unbiased healthcare think tank. It is funded and supported by major U.S. research-based biopharmaceutical and biotechnology companies, which have echoed the authors’ remarks for years in their efforts to sustain unreasonable profits. The council has among its member roster the likes of Amgen, AstraZeneca, Bayer, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, and Eli Lilly.

(Article may require a subscription.)

#drugpricing #branddrugmakers

https://www.healthaffairs.org/content/forefront/myths-mandatory-international-reference-pricing-prescription-drugs

— Marc S. Ryan

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