ACA’s Co-Op Health Plans Report Varied Enrollment Figures
The not-for-profit, consumer-owned and -operated health insurance plans established under the Affordable Care Act to boost insurer competition have had mixed success since the launch of the law's open enrollment period, the New York Times reports (Abelson et al., New York Times, 2/26).
John Morrison, outgoing chair of the National Alliance of State Health Co-Ops, on Tuesday said at an annual NASHCO meeting in Washington that about 300,000 individuals so far have enrolled in the co-ops, which is about 8% of the estimated four million individuals who have signed up through the exchanges (Demko, Modern Healthcare, 2/26). According to Morrison, the co-ops have overall garnered between 15% and 20% of the total enrollment market in their states.
The co-ops currently operate in about 23 states. However, three co-ops -- Kentucky Health Cooperative, Massachusetts' Minuteman Health and Montana Health Co-Op -- will expand into neighboring states next year (Hancock, "Capsules," Kaiser Health News, 2/27).
The sign-up figures have varied sharply among the 23 co-ops, Modern Healthcare reports. For example, a few exchanges reported particularly high enrollment figures, including:
- CoOpportunity Health, which operates in Iowa and Nebraska, has enrolled over 50,000 individuals, representing more than 400% of the plans' initial projections for 2014 enrollment;
- Kentucky Health Cooperative has enrolled more than 60% of the state's exchange business; and
- Maine Community Health Options has enrolled about 80% of the state's exchange enrollments (Modern Healthcare, 2/26).
According to the Times, the health co-ops in Montana, New Mexico and New York also are garnering a larger share of the enrollment market, partly because they have fairly competitive insurance packages and pricing.
Meanwhile, other exchanges have reported considerably lower enrollment figures, including:
- Connecticut's HealthyCT, which has enrolled about 1,700 individuals or roughly 3% of the market;
- Maryland's Evergreen Health Co-Op, which has signed up about 600 individuals; and
- Michigan's Consumers Mutual, which is lagging behind its 2014 projections.
The health co-op in Illinois also has reported low enrollment figures, according to the Times (New York Times, 2/26).
Co-Op Enrollment Obstacles
According to Modern Healthcare, the co-ops' mixed success results is partly related to several challenges. For example, although co-ops received about $2 billion in funding under the ACA, they were prohibited from using any federal funds for advertising purposes (Modern Healthcare, 2/26).
Meanwhile, some of the struggling co-ops, such as Maryland's Evergreen Health Co-Op, were hit particularly hard by the technical glitches that plagued the federal exchange website and many state-operated exchange sites, the Times reports.
In addition, co-ops tended to struggle with plan pricing, according to the Times. For example, co-ops in Michigan and Illinois failed to offer low premiums compared with standard exchange plans, and subsequently have continued to struggle with low enrollment figures. According to the Times, co-ops offered the lowest-priced premium in about one-third of the markets where they are operating.
HHS spokesperson Joanne Peters defended the enrollment figures, stating that co-ops "are providing new models for delivery of care, giving more choices and control to consumers, promoting competition and improving quality in the health insurance market." She added that the administration has "implemented a range of controls and methods to monitor and assess how they are performing" (New York Times, 2/26).