The nonprofit co-ops established with federal loans under the Affordable Care Act to offer health coverage through government insurance exchanges lost tens of millions of dollars last year, and most fell short of enrollment goals, the Associated Press reports, citing an audit by the Department of Health and Human Services inspector general.
Of the 23 state-level co-ops, officially called Consumer Operated and Oriented Plans, only Maine's ended 2014 in the black, with others losing from $3.5 million to $50.4 million. Thirteen co-ops missed their sign-up targets.
The nonprofit plans were launched with $2.4 billion in taxpayer-backed loans and an aim to compete with big insurers and hold down premiums. The audit raises concerns about whether the loans will be repaid and calls for closer government supervision of the co-ops. In a written response to the review, Andy Slavitt, the head of Medicare, said the administration agrees with the findings and recommendations but also noted that as startups the co-ops "enter the health insurance market with a number of challenges."