Dissolving Oregon co-op's members can apply out-of-pocket costs to new carriers
- Oregon's Health CO-OP, one of the health co-ops created under the ACA, announced Monday its members can purchase a plan from a new carrier and receive credit for money already paid toward deductibles and out-of-pocket maximums.
- Earlier this month, the co-op dropped a bombshell announcing it will fold at the end of this month and about 20,600 individuals will need to find new health coverage by Aug. 1.
- Days after Health CO-OP made its closure announcement, Illinois' co-op Land of Lincoln announced it would close. This leaves seven of the original 23 health co-ops still standing.
The risk adjustment program is a permanent program and redistributes funds from plans with lower-risk policyholders to those with high-risk policyholders.
Oregon's Health CO-OP has about 12,000 policyholders in the individual market and 10,000 in the small and large group markets. As The Bend Bulletin's Tara Bannow noted, "Current individual policyholders are eligible for a special enrollment period through HealthCare.gov until Sept. 29, but the state is encouraging them to enroll before the end of July for coverage that’s effective Aug. 1."
“It is unusual for plans to be canceled in the middle of the year, so we have been working hard and thinking creatively about how to better this situation for consumers,” said Patrick Allen, Oregon Department of Consumer and Business Services director, in a prepared statement. “Although CO-OP members will have to switch plans, they will not lose the money they already have paid into their plan for deductibles and other out-of-pocket expenses.”
Kevin Counihan, CEO of HealthCare.gov at CMS, recently defended the co-op program, Morning Consult's Mary Ellen McIntire reported. Speaking with a subcommittee of the House Committee on Oversight and Government Reforms, he stated the co-ops had incited innovation within the marketplace and given insurance-seeking individuals more plan options.
“This is a tough industry, as you very well know. It’s very tough to be a small business, and it’s tough to be a small health insurance company,” Counihan was quoted in Morning Consult. “We’re doing everything that we can to collaborate with the state departments of insurance and with the co-ops to make them successful.”
Counihan, while allowing a myriad of reasons could be determinants for why co-ops are profitable, declined to call the system a "total failure," Morning Consult noted. “Another perspective on that is that because of these co-ops we’ve been able to give people more choice,” he was quoted.
- Healthcare Dive Will risk-adjustment payments be the end for co-ops?
- The Bend Bulletin State: All CO-OP members should find new policies
- Healthcare Dive Health insurance market entrants face cold, lonely path ahead
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