CO-OPs squeeze premiums

April 25, 2014 at 01:14 PM
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A trade group for health insurance co-ops says the nonprofit, member-owned plans are helping to hold down coverage prices in their markets.

The National Alliance of State Health CO-OPs says its 23 member plans now have 400,000 enrollees — up from none on Sept. 30, before first Patient Protection and Affordable Care Act exchange system open enrollment period began.

PPACA drafters created the Consumer Operated and Oriented Plan program to try to increase the level of competition in the commercial health insurance market. CO-OPs are supposed to sell coverage through the PPACA exchanges mainly in the individual or small-group markets.

CO-OPs also can sell coverage outside the exchange system, and they can sell some coverage to large groups.

NASHCO said one study found that overall health premium rates in a state with a CO-OP are about 9 percent lower than rates in states without a CO-OP.

Analysts at McKinsey found that CO-OPs offered 37 percent of the lowest-priced plans sold through their states' public exchanges, NASHCO said.

Mark Bertolini, the chairman of Aetna Inc., talked about the CO-OPs effects on coverage prices Thursday during the company's first-quarter earnings call.

Aetna withdrew from some states' public exchange programs because the company believes the CO-OPs in those states are charging irrationally low rates, Bertolini said.

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