'; if(pArray.length >= 4) { i=2; } else if(pArray.length >= 3) { i=2; inline = ''; } else if(pArray.length >= 2) { i=1; inline = ''; } else if(pArray.length === 1) { i=0; inline = ''; } $('#librarydrawer_story_container script').each(function() { $(this).remove(); }); $(pArray[pArray.length - 1]).after(subscribeBox); $(pArray[i]).after(inline).after($('#librarydrawer_story_container')); $('#text-story').focus(function() { if ($(this).val() == 'EMAIL ADDRESS') { $(this).css({color: '#000000', backgroundColor: '#ffffff'}); $(this).val(''); } }); $('#text-story').blur(function() { var trim = $(this).val().replace(/[\s]/g, ''); if(trim === '') { $(this).val('EMAIL ADDRESS'); $(this).css({color: '#666666', backgroundColor: '#f8f8f8', border: '#666666 1px solid'}); } }); $('.content-subscribe .btn-submit').click(function() { var val = $('.content-subscribe .text').val(); if(val.search(/[a-z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\.[a-z0-9!#$%&'*+\/=?^_`{|}~-]+)*@(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?/gi) === -1) { $('.content-subscribe .text').css('border', '#ff6600 1px solid'); $('.content-subscribe .text').focus(); return false; } return true; }); }); //-->

Struggling CO-OPs enter a pivotal year amid signs of potential growth

Despite multi-million losses in 2015, officials say growing enrollment, and a stable patient population could save CO-OP plans

Although nearly half of Affordable Care Act consumer operated and oriented plans (CO-OPs) shut down, and many reported multi-million losses last year, officials say 2016 could be a rebound year for the frequently maligned plans, according to the Associated Press.

Last week, a Senate subcommittee blamed officials at the Centers for Medicare & Medicaid Services (CMS) for authorizing more than a billion dollars in loans to CO-OPs despite clear signs of financial distress. The struggling CO-OPs have been a frequent target of criticism from lawmakers that say CMS encouraged the plans to "cook their books."

Despite overwhelming losses in 2015, CO-OP officials say enrollment is growing and a healthier patient mix is mitigating the losses suffered during the previous year. CO-OP enrollment surged to 350,000, three times the total in 2014, according to the AP.

Although 2015 losses ranged from $10 million to more than $90 million in 2015, Kelly Crowe, CEO of the National Alliance of State Health CO-OPs, told the AP that plans are still fragile, but they are showing signs of improvement.

For example, Evergreen Health in Maryland turned a profit in three of the last six months of 2015, and thanks to younger, healthier enrollees, the plan expects to be profitable in the coming year. Montana's CO-OP raised premiums 36 percent without losing membership and found some relief when the state expanded Medicaid and took on high-cost patients.

Still, the plans face several barriers. CO-OP leaders say the beneficiary risk adjustment formula favors established insurers, and a federal program designed to help CO-OPs manage large medical bills is set to expire this year.

CO-OP failures have emerged as a political talking point amid reports that the government failed to act on flailing plans. Last year, the Office of Inspector General (OIG) found nearly all of the 23 CO-OPs failed to meet initial enrollment goals, and CO-OP leaders have said it will be nearly impossible to pay back more than $1 billion in loans provided to failed plans.

To learn more:
- read the AP article

Related Articles:
Senate subcommittee blames CMS officials for funding failing CO-OPs
OIG report finds CO-OPs underperformed, didn't reach enrollment goals
CO-OP leaders fear feds may not be able to recoup loan money
Lawmakers slam oversight of failing CO-OPs
Why as CO-OPs failed, government failed to act
CO-OP fallout: Failures become political battleground