- Colorado HealthOP, the state’s largest nonprofit insurer, was unable to overturn the decision of the state’s Division of Insurance to decertify the health cooperative, reported Modern Healthcare.
- Following the announcement of its removal from the state’s insurance marketplace last week, the nonprofit sued the Division of Insurance, reported the Denver Business Journal.
- As a result, 83,000 members will need to find new coverage when open enrollment begins Nov. 1.
More than a third of the 23 co-ops organized under the ACA have failed. Last week, Oregon and Colorado’s co-ops were on the chopping block, as previously reported by Healthcare Dive.
Both shutdown announcements come on the heels of the announcement that the Centers for Medicare and Medicaid Services will only reimburse a fraction of what insurers were promised under the “risk corridors” program, which was supposed to cushion the risk for insurers taking on new high-risk enrollees under the ACA.
Colorado HealthOP was the first of such health cooperatives to sue over a forced closure. Maine Community Health Options, Maine’s health co-op, was the only agency of the 23 co-ops to make money, according to an earlier HHS Office of Inspector General report.
It’s hard to report on one co-op closure without another one announcing closed doors before you hit the “publish” button. In response to such rapid-fire announcements, some co-ops and small insurers “are forming a coalition to consider legal action to try to change health-law provisions they blame for their financial distress,” reported The Wall Street Journal.
Formed from the not-yet-existent ashes of surviving health co-ops, small insurers and benefits providers, the coalition will seek changes to the federal risk adjustment formula, The Wall Street Journal reported.