Insurance startup joins ACA market in Houston
Oscar, a fast-growing, techbased insurance startup, will offer individual plans for 2020 through the Affordable Care Act’s exchange for the first time in Houston, the company said Thursday
The New York insurer already has an established footprint in Texas with 60,000 members — nearly a quarter of its national membership. It sells individual plans on the exchange in Austin, Dallas-Fort Worth, El Paso and San Antonio but has been absent from Houston.
In July, the company said it had picked Houston and New York as the sites of its inaugural launch of a Medicare Advantage program for seniors. At the time, Dr. Dennis Weaver, chief clinical officer for Oscar, hinted it may also soon offer individual plans in Houston.
“We are excited to bring our personalized approach to the residents,” Mario Schlosse, the company CEO and co-founder, said in a statement on Thursday. “By expanding, we have the opportunity to serve more members and ensure access to the highest quality of care while making it more transparent and more affordable in the process.”
The 7-year-old company was founded by three Harvard Business School classmates after they experienced difficulty navigating the insurance and medical billing systems. Its name, Oscar, comes from the great-grandfather of co
founder Josh Kushner, younger brother of Jared Kushner, who is the son-in-law of President Donald Trump.
Oscar’s entrance into the Houston market brings to five the number of companies offering individual plans for next year and could indicate further market stabilization after several rocky years for the health care law.
Not so long ago, UnitedHealthcare, Aetna, Humana, and Cigna all announced
they would stop offering individual plans through the exchange in Texas for 2017. Regional carrier Scott & White Health Plan also fled the exchange, and even Oscar, a newcomer at the time in other parts of the state, announced it would limit its offerings.
The insurers that remained began to then implement huge rate increases. But since then, insurers have said they have learned how to better set rates and have reported increased profits. In fact, for 2020, three of the four previously announced companies offering plans in Houston will lower premium prices from a year ago.
Specifics of the Oscar’s Houston plans were not immediately available. A company spokeswoman confirmed, however, coverage would be through exclusive provider organization plans, a type of managed care plan in which services are covered only if the patient goes to doctors, specialists or hospitals within its network, except in emergency situations.