Is that CO-OP dead? Or alive but dying?

Medium data

In GAO and HHS OIG reports, some CO-OPs that were still in business on Oct. 29 appeared to be weaker than those that had announced plans to close. In GAO and HHS OIG reports, some CO-OPs that were still in business on Oct. 29 appeared to be weaker than those that had announced plans to close.

The reasons for the recent wave of Consumer Operated and Oriented Plan (CO-OP) failures may be open to debate, but one fact is clear: Many agents, brokers and health policy watchers have been looking for a good CO-OP status list.

See also: Health plan sick list: South Carolina, Wyoming, Kentucky, Illinois

Drafters of the Patient Protection and Affordable Care Act of 2010 (PPACA) created the CO-OP program in an effort to increase the level of competition in the health insurance market.

Since President Obama signed PPACA into law, the Republicans have strengthened  their position in Congress, key Democratic backers of the CO-OP program have left Congress, and one of the major PPACA health insurance company support programs that CO-OP managers were counting on has performed poorly.

See also: Feds: PPACA risk program may pay just 13% of 2014 claims 

After the Centers for Medicare & Medicaid Services (CMS) announced that the PPACA risk corridors program, which is supposed to use cash from thriving PPACA public exchange plan issuers to help struggling issuers, might collect only enough cash to pay about 13 percent of the amounts owed to the struggling issuers, a trickle of CO-OP shutdown news gave way to a steady flow of similarly-worded shutdown notices.

One sign that more shutdown notices could be in the pipeline is that, in CO-OP reports released this summer, some of the CO-OPs that have said they are closing appeared to be stronger than some of the CO-OPs that have not released shutdown notices.

CO-OP watchers have spent time flipping between the tables in the attractively formatted CO-OP review issued by the U.S. Government Accountability Office (GAO) and a data-rich CO-OP update prepared by the U.S. Health and Human Services Office of Inspector General (HHS).

For a look at a CO-OP status table, based on the data our staff was able to find as of noon Oct. 29, read on. 

 CO-OP status table

State

Name

Status

Startup and solvency loan total

December 2014 enrollment*

2014 revenue

2014 net results

      (millions)   (millions) (millions)
Arizona Meritus Health Partners  Alive 93 869 5 -7.2
Colorado Colorado HealthOP Dying 72 14,657 55 -23
Connecticut HealthyCT Alive 128 7,966 23 -28
Illinois Land of Lincoln Health Alive; enrollment growth capped 160 3,461 14 -18
Iowa and Nebraska CoOportunity Health Dead 146 76,762 N/A N/A
Kentucky Kentucky Health Care Cooperative  Dying 146 56,680 244 -50
Louisiana Louisiana Health Cooperative Dying 66 9,980 46 -21
Maine Maine Community Health Options Alive 133 39,742 168 5.9
Maryland Evergreen Health Cooperative Alive 65 11,694 12 -15
Massachusetts and New Hampshire Minutemen Health Alive  156 1,700 2.9 -20
Michigan Consumer’s Mutual Insurance of Michigan  Alive 72 11,122 15 -16
Montana and Idaho Montana Health Cooperative Alive 85.1 13,160 42 -3.5
Nevada Nevada Health Cooperative  Dying 66 16,523 52 -15
New Jersey Health Republic Insurance of New Jersey Alive 109 4,254 20 -16
New Mexico New Mexico Health Connections Alive 77 14,297 32 -4.3
New York Health Republic Insurance of New York Dying 265 155,402 529 -35
Ohio InHealth Mutual Alive 129 6,677 15 -5.9
Oregon Oregon's Health CO-OP Alive 57 1,582 3.8 -6.8
Oregon Health Republic Insurance of Oregon Dying 60 8,813 26 -14
South Carolina Consumers’ Choice Health Insurance Company (South Carolina) Dying 88 45,668 165 -3.8
Tennessee Community Health Alliance Mutual Insurance Company Dying 73 2,287 6.6 -22
Utah Arches Mutual Insurance Company Dying 90 22,397 53 -20
Wisconsin Common Ground Healthcare Cooperative  Alive 108 26,034 124 -37

* The CoOportunity enrollment figure is for June 30, 2014.

Sources: U.S. Government Accountability Office, GAO-15-304 Consumer Operated and Oriented Plans, and U.S. HHS OIG Actual Enrollment and Profitability Was Lower Than Projections Made By The Consumer Operated and Oriented Plans.

 

See also: Watchdog: CMS is giving 4 CO-OPs' finances extra attention and Surviving PPACA CO-OPs may have 475,000 enrollees

 

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