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October 04, 2016 at 12:06 PM
Managers of Evergreen Health, Maryland’s Consumer Operated and Oriented Plan carrier, hope to keep the carrier going by getting it out of the CO-OP program and into the hands of private investors.
Dr. Peter Beilenson, the chief executive officer of the nonprofit, member-owned company, said Monday that the private investors would convert the company to for-profit status.
Related: ACA: CCIIO Peers Into CO-OP Future
The Baltimore-based company is applying for permission from the Centers for Medicare & Medicaid Services (CMS) to proceed with the deal, as an alternative to shutting the carrier down.
Evergreen, one of the six surviving Affordable Care Act CO-OP program carriers, now provides coverage for about 38,000 people.
ACA drafters created the CO-OP program to bridge a gap between ACA supporters who wanted the federal government to offer a government-run “public option” health insurance program and supporters who hoped to solve U.S. health finance problems by increasing the level of competition in the commercial health insurance market.
The ACA program provided startup loans for nonprofit groups that wanted to start nonprofit CO-OP carriers.
Early on, CMS officials put tight limits on CO-OPs’ activities. CMS ruled, for example, that no established health insurer could invest in a CO-OP or have an executive on a CO-OP board, and that the member owners of a CO-OP could never sell a CO-OP to any other party. CMS also put strict limits on CO-OPs’ ability to use CMS startup loans on marketing.
