The lone health insurance cooperative to make money last year on the Affordable Care Act's public insurance exchanges is now losing millions and suspending individual enrollment for 2016.
Maine's Community Health Options lost more than $17 million in the first nine months of this year, after making $10.9 million in the same period last year. A spokesman said higher-than-expected medical costs have hurt the cooperative.
The announcement casts further doubt on the future of the cooperatives, small nonprofit insurers devised during the ACA's creation to inject competition in insurance markets. These co-ops immediately struggled to build their businesses. A dozen of the 23 created have already folded.
An Associated Press review of financial statements from 10 of the 11 surviving co-ops shows that they lost, on average, more than $21 million in the first nine months of this year. Those losses range from $3.9 million reported by Maryland's Evergreen Health Cooperative to $50.7 million booked by Land of Lincoln Mutual Health Insurance Co. in Illinois.
"Clearly the remaining health care co-ops are in dire circumstances," said Robert Laszewski, a health care consultant and former insurance executive who has been a frequent critic of the Affordable Care Act. "I don't know how any of them can survive another year."
The state-based co-ops were seen as a fallback option by liberals who initially wanted a government-run insurer to compete with for-profit companies that control the U.S. commercial coverage market.
The cooperatives, like other health insurers, have been hit by soaring medical and prescription drug costs. Plus they've had to spend money building a network of care providers, negotiating rates with them and then marketing their plans to customers. They have also received considerably less financial support than they expected from a federal government program designed to support insurers as the exchanges got under way.