Health Insurance CO-OPs Enroll Over 1 Million in 2015

NASHCO releases aggregate enrollment figures from its member CO-OPs operating in 23 states; CO-OP enrollment more than doubles in a year
March 25, 2015


WASHINGTON – Over 1 million people have enrolled in CO-OP health insurance plans, the National Alliance of State Health CO-OPs (NASHCO) announced today. As of March 25th, CO-OPs boasted over 1 million effectuated members. While this number reflects the most recent ACA enrollment period, it remains fluid with ongoing off-marketplace and special enrollment. At the conclusion of the 2014 enrollment period, NASHCO reported CO-OPs had enrolled just over 400,000 members.


“Health insurance CO-OPs have built on their significant early progress, and the proof is in the large increase in the number of lives they are now covering,” said Dr. Martin Hickey, Chair of NASHCO’s Board and President and CEO of New Mexico Health Connections. “These numbers are further evidence that CO-OPs are making a real impact on the health insurance marketplaces in their states – an impact that goes well beyond enrollment numbers. Indeed, health insurance CO-OPs are driving innovation, competition, and affordability across the country.”


For the second year in a row, average premium rates in states with CO-OPs are lower than those without CO-OPs. For 2015, an analysis of the second-lowest cost silver plans major cities in each state found average premium rates in CO-OP states fell by 1.9% since 2014, while average premium rates in non-CO-OP states rose by 1.5%. The same analysis showed the average monthly premium difference between CO-OP and non-CO-OP states had increased to 12%.


A similar analysis from 2014 showed CO-OP states with 8-9% lower premiums than non-CO-OP states. These figures suggest that the competition created by the mere presence of a CO-OP is leading to lower premium rates, resulting in savings for premium holders and taxpayers alike.


CO-OPs are also making a real impact on innovation – another one of their intended purposes. CO-OPs are taking unique and individualized approaches to truly shake up the health insurance landscape. These include new payment models, the use of patient centered medical homes, and a real focus on combating behavioral health and chronic disease. Long before President Obama announced the goal of transitioning away from a fee-for-service model of health care payments, many CO-OPs have been experimenting with their own versions of outcome-based care.


The aggregate enrollment figure is based on data compiled from member CO-OPs by the National Alliance of State Health CO-OPs. Requests for specific CO-OP enrollment figures cannot be accommodated by NASHCO.


Based in Washington, DC, the National Alliance of State Health CO-OPs is the trade association for non-profit health insurance CO-OPs. NASHCO was formed after the passage of the Affordable Care Act, and was designed to promote the development and success of health insurance CO-OPs. All 22 health insurance CO-OPs are members of NASHCO. In the last four years, NASHCO has hosted multiple conferences to bring together those interested in the innovations and member governance models of CO-OPs, including health care policy experts, administration officials and congressional staff, health care industry professionals, and employer groups and consumer advocates. For more information, visit