CMS Data Just Landed. The ACA Did Not Collapse. And the Fear Was Wrong. $OSCR

I did not expect to write another update today. But the CMS enrollment data that just came out is simply too important to ignore.

For months, the dominant narrative around the ACA market was fear. Headlines, analysts, and institutions warned of a 15 to 20 percent collapse in enrollment. The assumption was simple. Without enhanced subsidies, the ACA would unravel quickly. Oscar Health would be hit hard. The market priced that fear aggressively.

Today, the data tells a very different story.

According to the most recent CMS enrollment snapshot, total ACA marketplace enrollment is down roughly 3.5 percent year over year. That is it. Not 15 percent. Not 20 percent. Single digits.

This data is extremely recent and comes just days before the end of open enrollment. It directly contradicts the most bearish assumptions that dominated the discussion for months.

Let’s put this into context.

Oscar Health’s most important states based on historical concentration are Florida, Georgia, and Texas.

Florida enrollment is down roughly 3.4 percent.

Georgia enrollment is down roughly 12.8 percent.

Texas enrollment is up roughly 6.5 percent.

At first glance, this looks mixed. But this is exactly where surface level analysis fails.

The expectation from institutions and policy analysts was a broad based collapse of the ACA market. A systemic breakdown. That simply did not happen. Even Georgia’s decline must be viewed in the context of pricing adjustments, plan restructuring, and subsidy mechanics rather than demand destruction.

The market as a whole is down only about 3.5 percent. That alone invalidates the bear thesis that dominated sentiment.

On a weighted basis by state, Oscar appears to be down roughly 5 to 6 percent. That aligns closely with my own expectations of a mid single digit decline, not the disaster scenarios that were priced into the stock.

Why this matters.

The ACA is a government subsidized system. Even without enhanced subsidies, regular subsidies cap premiums at 8.5 percent of income. That cap exists regardless of plan pricing. The system has an automatic stabilizer built into it.

Insurers can raise prices on lower tier plans. The subsidy adjusts. Consumers do not feel the full increase. That is how enrollment remains resilient. This is not theory. This is how the ACA was designed to function.

Now combine that with Oscar’s positioning.

Oscar offers some of the most competitive plans in the ACA market. Lower prescription costs. In many cases three dollar prescriptions versus ten to fifteen dollars at competitors. That matters deeply for lower income households on subsidized plans.

Oscar is also highly data driven. AI driven. Focused on pricing discipline, member quality, and state level optimization. They are not trying to win every market. They are trying to win the right markets.

During open enrollment, consumers shop. They compare plans. They compare out of pocket costs. Oscar is positioned extremely well in that environment.

The fear was that demand would disappear. The data shows demand held up.

This CMS release is one of the most important data points we have been waiting for. It directly challenges the narrative that drove the stock lower. It shows that the ACA did not implode. It bent slightly and stabilized.

We are now heading into earnings season. The 8-K. The 10-K. Full state level membership disclosures. This is where speculation ends and reality takes over.

My view has not changed.

The fears were overblown. The market extrapolated worst case scenarios without waiting for the data. This is exactly how mispricings are created.

This is why I focus on durable systems tied to essential human needs. Healthcare does not disappear because of political noise. Insurance does not vanish overnight. Systems with built in subsidies and structural demand are far more resilient than headlines suggest.

My personal position remains unchanged. I continue to hold Oscar Health with high conviction. I view the recent volatility as fear driven rather than fundamentals driven.

This was not about guessing. It was about waiting for the data.

The data is now here.

And it tells a very different story than the market feared.