ACA Government Co-Ops: Is This Experiment Working In Your State?

[ActuaryGuy]

The article says that Health Republic can't even wind down until the end of the year, they have to term everyone 11/30. So consumers will have to re-enroll for that one month of December. And then open enroll again. What a mess.

If I read it correctly, I thought it said that they can still special enroll through November, which makes no sense.

 

[AllenChicago]

You have Health Republic of NY listed twice as #5 and #13. It is still scary the comments from the NY DOI about the financials being worse than previously stated.

Thanks for the heads-up. Maybe Health Republic just went under but was able to come up for air the first time? Anyway, they're DOA now (maybe?). Will edit/correct by removing the #5 entry and renumbering. Thanks again.

BTW...Illinois LOLH Co-op is really throttling back. Only a few plans available per county. That's too bad because their benefits and PPO network is superior to everyone in 2016.

 

[HealthRisk]

Thanks for the heads-up. Maybe Health Republic just went under but was able to come up for air the first time? Anyway, they're DOA now (maybe?). Will edit/correct by removing the #5 entry and renumbering. Thanks again.

BTW...Illinois LOLH Co-op is really throttling back. Only a few plans available per county. That's too bad because their benefits and PPO network is superior to everyone in 2016.

I think the #5 entry stands. They said they were closing their doors on 12/31 awhile back and "failed" then. The notice that recently broke this last week has shifted the date up to 11/30 because they are broke.

Now the mad scramble for all those folks to find different coverage for December and separately re-enroll during open enrollment for 2016.

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The article says that Health Republic can't even wind down until the end of the year, they have to term everyone 11/30. So consumers will have to re-enroll for that one month of December. And then open enroll again. What a mess.

If I read it correctly, I thought it said that they can still special enroll through November, which makes no sense.

The article indicates the financials they provided earlier might not have been reliable. Yikes.

 

[AllenChicago]

November 2, 2015

Co-op News from my birth state..

'It appears that East Lansing-based Consumers Mutual Insurance of Michigan could wind down operations this year, as it is not participating in the state health insurance exchange for 2016."

Source: http://www.crainsdetroit.com/articl...umers-mutual-co-op-could-wind-down-operations

Consumers Mutual stopped selling policies in the higher-risk counties, but apparently that wasn't enough.

 

[AllenChicago]

Tuesday, November 3, 2015

WASHINGTON, DC – The Energy and Commerce Subcommittee on Oversight and Investigations, chaired by Rep. Tim Murphy (R-PA), today announced the witnesses who will testify at the Congressional hearing convening on Thursday, November 5th, for "Examining the Costly Failures of Obamacare's CO-OP Insurance Loans." The hearing comes just days after the state of Arizona announced that its CO-OP would shutter in 2016, bringing the total to 11 out of the original Obamacare 23 CO-OPs that will be out of operation in 2016 at a total cost to taxpayers of $1.165 billion.

Source: #SubOversight Announces Witnesses for Hearing on Mounting Obamacare CO-OP Failures | Energy & Commerce Committee

 

[Ann H]

Looks like Michigan's co-op has fallen:

https://www.washingtonpost.com/nati...a95b86-824b-11e5-9afb-0c971f713d0c_story.html

 

[RayNY]

All I can think of hearing all this co-op news

 

[AllenChicago]

Looks like Michigan's co-op has fallen:

https://www.washingtonpost.com/nati...a95b86-824b-11e5-9afb-0c971f713d0c_story.html

Wednesday, November 4, 2015

Thank-you Ann. With yesterday's announcement that Consumer's Mutual Insurance of Michigan is shutting down operations..

It's time to update the list..

The Affordable Care Act (aka ObamaCare) set up 23 state Co-Ops on January 1, 2014. These have gone belly-up, after just two open enrollment seasons:

1. Vermont - Was squashed based on poor financial projections.

2. Co-Opportunity Health - Iowa/Nebraska

3. Louisiana Health Cooperative - Louisiana

4. Nevada Health Co-op - Nevada

5. Kentucky Health Cooperative - Kentucky

6. Community Health Alliance - Tennessee

7. Colorado HealthOP - Colorado

8. Health Republic Insurance - Oregon (1 of 2 in the state)

9 . Consumers' Choice Health Plan - South Carolina

10. Arches Health Plan - Utah

11. Meritus Health Plans - Arizona

12. Health Republic Insurance - New York

13. Consumer's Mutual Insurance - Michigan

Taxpayers have now been exposed to a disgusting 57% failure rate of this U.S. Government experiment. The Obama Administration endorsed using our money to test a crazy theory that's failing miserably.

These Consumer Oriented and Operated Plans are imploding on a weekly basis, yet U.S. Government leaders don't care, because only "a few million" insureds, patients, medical providers, and employees will suffer. What we're witnessing is an example of what would happen to an underfunded national Single-Payer system, IMO.

ac

 

[AllenChicago]

Tuesday, November 3, 2015

WASHINGTON, DC – The Energy and Commerce Subcommittee on Oversight and Investigations, chaired by Rep. Tim Murphy (R-PA), today announced the witnesses who will testify at the Congressional hearing convening on Thursday, November 5th, for "Examining the Costly Failures of Obamacare's CO-OP Insurance Loans." The hearing comes just days after the state of Arizona announced that its CO-OP would shutter in 2016, bringing the total to 11 out of the original Obamacare 23 CO-OPs that will be out of operation in 2016 at a total cost to taxpayers of $1.165 billion.

Source: #SubOversight Announces Witnesses for Hearing on Mounting Obamacare CO-OP Failures | Energy & Commerce Committee

November 6, 2015

Summary of this past week's Congressional Hearing:

"During a House Ways and Means subcommittee hearing that was one part status report and one part post-mortem, Mandy Cohen, the chief operating officer of the Centers for Medicare and Medicaid Services, which operates Obamacare, said the administration was essentially cutting its losses while keeping close watch on the surviving health insurance co-ops."

Full Story: The White House won't be saving the failing Obamacare co-ops - Business Insider

 

[RayNY]

News was released this week that HRINY, in addition to being in such a dire situation that immediate shutdown was required, has at least $142 million in outstanding claims payments due to hospitals.

This is in addition to months of commissions, and a year worth of bonuses that were never paid to brokers.

They additionally have not paid their PBM, Express Scripts, and members no longer have drug coverage even though their premiums have been paid and HRINY can confirm active status.

It turns out, they didn't have a working termination system. Members stayed active for 12-18 months with no payment posted. They're currently trying to bill members for this coverage (huge bills, I've seen $6,000-10,000), and have hired a collection agency to directly pursue members.

The state has stepped in an put someone in place to oversee the wind-down, the company is now out of exec's hands.

GNYHA is lobbying for new laws that would create a healthy guaranty fund to retroactively pay providers what they are owed when carriers fail.

Since that's not in place, and not likely to pass, providers are left with two options- eat the loss, or bill patients.

This situation is getting very messy...