Don’t take my word for it. Check out what others have said about Adam Cancryn’s coverage of the growing number of failures among the health insurance co-ops.
In a piece for the Columbia Journalism Review, Trudy Lieberman wrote “Adam Cancryn’s Nov. 11 article for SNL Financial on America’s incredible shrinking insurance co-ops is the story I’ve been waiting for someone to write: the best account to date of why, and how, the insurance co-op experiment is failing,” Lieberman wrote, adding that it’s “one of the best Obamacare stories I’ve seen since the debate on the law began.” Continue reading
When drafting the Affordable Care Act in 2010, Congress wanted to foster competition among health insurers. So it offered loans to nonprofit organizations that wanted to start health insurance consumer oriented and operated plans (called co-ops) in the states.
In theory, the co-ops are a great idea to increase competition and consumer choice. Congress included $2.4 billion in the ACA to establish these member-operated health insurance plans. The co-ops are particularly important today because five of the largest health insurers could soon be reduced to three if Anthem acquires Cigna and Aetna merges with Humana. Continue reading
We’ve written several times about the role of co-ops in the states (here and here) and posted a lot of resources for those of you in states with this option. But here’s a story from The Associated Press that surprised me – Vermont just rejected the Vermont Health Co-op, saying it was going to cost too much and was probably too optimistic about enrollment. (Regulators also raised questions about its solvency, which was less surprising if you’ve been following co-ops.)
The co-op is hoping to get that decision reversed so it may not be over. But this is noteworthy because it’s occurring in a small state that doesn’t have a lot of insurance participation in the exchange – something that backers of co-ops had hoped these nonprofit entities would address.
Vermont is a liberal state that backs health reform, and has created a framework for moving to a state version of a single-payer system a few years from now. And so far it has only two health plans set to offer coverage in its exchange next year. It’s the kind of state that – at least from the outside – one would have expected to work hard to find a space for the co-option. I welcome insight from anyone who knows Vermont well and has a different take.
I wrote about co-ops as an undercovered health reform topic last month and provided some resources about how to cover them, either from a big-picture perspective about their role in the exchanges across the country next year or if you are looking at co-ops in your state or region – if they exist.
Health Affairs and RWJF have published a brief that explains in more detail about how they are set up, and the challenges they face. The brief gives a description of several of the co-ops – here are the top three on the list to give a taste of the variety. (There are more in the brief and the National Alliance of State Health Cooperatives has a full list (PDF).
- Evergreen Health Cooperative, established by Peter Beilenson, a former Baltimore City health commissioner, intends to provide high-quality care to members throughout Maryland with premiums costing 20-30 percent less than those of traditional insurance to help keep people from developing more serious illnesses. It has been awarded $65 million in loans.
- HealthyCT is a nonprofit health plan sponsored by the Connecticut State Medical Society (CSMS) and CSMS-IPA, a statewide independent practice association of providers. HealthyCT will focus on encouraging members to use patient-centered medical homes. It has been awarded $76 million in loans.
- Compass Cooperative Health Network in Arizona is sponsored by local experts in insurance, chronic disease coordination, use of health information technology, and business formation. It will begin on a regional basis within Arizona and then expand statewide over time. It has been awarded $93 million.