Fiscal cliff deal shuts down loan program meant to launch state-based co-op health plans; 26 states will miss out.
Healthcare’s geographic variation was made all the more patchy by the fiscal cliff deal struck on January 1. The deal abruptly shut down a loan program meant to launch state-based co-op health plans-before all the states could take advantage of it.
Twenty-six states have now missed out on any real chance of creating co-op health plans simply because of unfortunate timing, while 24 states are moving forward with the federal co-op loans they secured in 2012. The program was part of the Patient Protection and Affordable Care Act.
In Congress’ deal, a remaining balance of $1.9 billion was trimmed away from the $3.8 billion program. The federal government will not renege on the loans granted to co-ops previously, but the program has come to an end.
Co-ops are not-for-profit, member-run health plans that follow the same rules as other insurers; however, they must reinvest any excess revenue into benefits and lower premiums. The startups would most likely aim to compete on price inside and outside of the insurance exchanges. Each will need to earn a license from the state and set up a board of directors that includes plan members.
Co-op organizations without federal loans will have a difficult time finding other resources. Even the active plans aren’t guaranteed success once open enrollment begins, and they must pay back the federal loans between five and 15 years’ time, regardless. A 10% cushion was allowed in the fiscal cliff deal to cover the administrative costs for the existing loans.
Federal Loans for Co-ops
Compass Cooperative Health Networkâ¨
Arizona
$93,313,233â¨
Colorado Health Insurance Cooperative, Inc.
Coloradoâ¨
$69,396,000â¨
HealthyCTâ¨
Connecticutâ¨
$75,801,000â¨
Land of Lincoln Health
Illinoisâ¨
$160,154,812â¨
CoOpportunity Health
Iowa and Nebraskaâ¨
$112,612,100â¨
Kentucky Health Care Cooperativeâ¨
Kentucky
$58,831,500
Louisiana Health Cooperative, Inc.â¨
Louisianaâ¨
$65,040,660â¨
Maine Community Health Options
Maineâ¨
$62,100,000â¨
Evergreen Health Cooperative Inc.â¨
Maryland
$65,450,900â¨
Minutemen Health, Inc.â¨
Massachusetts
$88,498,080â¨
Michigan Consumer’s Healthcare CO-OPâ¨
Michiganâ¨
$71,534,300
Montana Health Cooperativeâ¨
Montanaâ¨
$58,138,300â¨
Hospitality Health CO-OPâ¨
Nevadaâ¨
$65,925,396â¨
Freelancers CO-OP of New Jerseyâ¨
New Jerseyâ¨
$107,213,300â¨
New Mexico Health Connectionsâ¨
New Mexicoâ¨
$70,364,500â¨
Freelancers Health Service Corporationâ¨
New York
$174,445,000â¨
Coordinated Health Plans of Ohio, Inc.â¨
Ohioâ¨
$129,225,604â¨
Freelancers CO-OP of Oregon
Oregonâ¨
$59,487,500â¨
Oregon’s Health CO-OP
Oregonâ¨
$56,656,900
Consumers’ Choice Health Insurance Company
South Carolinaâ¨
$87,578,208â¨
Community Health Alliance Mutual Insurance Companyâ¨
Tennesseeâ¨
$73,306,700
Aarches Community Health Care
Utah
$85,400,303â¨
The Vermont Health CO-OP
Vermontâ¨
$33,837,800
Common Ground Healthcare Cooperativeâ¨
Wisconsin
$56,416,600
FDA Approves First At-Home Cervical Cancer Screening Device
May 15th 2025Self-collected samples to test for cervical cancer are a step in the right direction when it comes to addressing healthcare barriers, according to Rahma S. Mkuu, Ph.D., M.P.H., assistant professor in the Department of Health Outcomes & Biomedical Informatics at the University of Florida College of Medicine.
Read More
Conversations With Perry and Friends: Paul Fronstin, Ph.D.
May 9th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. In this episode, his guest is Paul Fronstin, Ph.D., director of health benefits research at the Employee Benefit Research Institute.
Listen
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen
The First Financial Toxicity Tumor Board Reports Success in Individual Patient Savings
May 14th 2025Financial toxicity can affect patient outcomes and quality of life. For example, a patient may forgo treatment or medications to save money, or they may incur high medical debt or go into bankruptcy to pay for medical care.
Read More