Political gamesmanship is killing ACA’s CO-OPs

By Debra Smith
The Louisville Courier-Journal
November 3, 2015


On Oct. 30, Arizona’s consumer oriented and operated plan (CO-OP), Meritus Health Plan, announced it would be closing its doors at the end of the year. It joins 10 other health CO-OPs, including Kentucky’s, winding down operations thanks to the current political environment.


The Affordable Care Act (ACA) was supposed to increase the available choices in health coverage, lower costs through more competition and get more people covered.


The health CO-OP under the ACA was to be a not-for-profit consumer-oriented, member-governed entity providing more affordable, quality health insurance coverage, and reinvesting any profits to directly benefit members — through lower premiums, expanded benefits, or quality improvements.


Much in the press has been written that the CO-OPs priced their products too low. This assumption is based on the fact that 17 of the 23 co-ops paid out money under the risk-adjustment program, which was supposed to balance the playing field, providing relief to those health plans with sicker members. However, this assumption is wrong…