Here are five takeaways:
1. Several ACA co-ops have closed midway through this year, leaving many patients to face escalated out-of-pocket costs and find new physicians. Nearly 92,000 ACA customers are seeking new plans after Illinois, Oregon and Ohio co-ops closed this year. In 2017, a Connecticut co-op will close, leaving thousands to seek new plans in the state.
2. Last year, an Iowa and Nebraska co-op, CoOportunity, closed in the middle of 2015, with CMS Acting Administrator Andy Slavitt saying they co-op should never have offered plans that year. He said, “I will say CoOportunity should never have been allowed to go into the 2015 year, either by the co-op or by ourselves, and I think that’s a very fair criticism in looking back.”
3. With the seven co-ops’ uncertain future, many are wondering if CMS will step in to shut down these co-ops at the best time, rather than the middle of the year. CMS spokesperson Aaron Alrbought said while CMS regularly speaks with state insurance departments, state DOIs are the main regulators within their own states.
4. However, sources familiar with the matter say CMS is not always in accordance with state regulars and was not aware state regulators were shutting down co-ops in Ohio, Oregon or Connecticut.
5. Some claim the co-ops failed due to the ACA’s risk adjustment program, which has been the source of many co-op lawsuits against the health law.
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