- The Washington Times - Wednesday, December 9, 2015

An Obamacare co-op that offered one of the program’s few success stories said Wednesday it will suspend enrollment for 2016, marking another black eye for nonprofit plans that were supposed to give consumers a leg up in the marketplace.

The Community Health Options plan of Maine said it cannot accept new customers in the individual market after Dec. 26.

The decision to curtail enrollment, which does not apply to its small-group line of business for employers, “is a consequence of significant enrollment growth over the last two years and higher than expected claims costs in 2015,” the co-op said in a statement on its website.

Though customers will have until Dec. 26 to enroll on Obamacare’s Web-based marketplace, those who want to buy an individual plan directly from the co-op must do so by Dec. 15.

Co-op board chairman Jim Davis said existing customers will not be affected by the decision.



“Members, both new and renewing, can rest assured that their 2016 coverage remains in full force and effect,” he said. “We look forward to the eventual resumption of additional individual enrollment.”

The announcement comes as a surprise, as Maine’s co-op was considered a rare bright spot among co-op plans that struggled in Obamacare’s first two years.

So far, 12 out of the initial 23 co-op plans have failed. The program, backed by $2.4 billion, was written into the Affordable Care Act to offer an alternative to corporate players in the marketplace.

Some of the plans faced fiscal growing pains and went belly up this fall, after the administration said Oct. 1 that it could pay less than 13 percent of what insurers had requested from a “risk corridor” program designed to protect against heavy losses in the marketplace.

Maine’s co-op was the only one to make money in 2014, although it was helped by the fact that only one other insurer, the for-profit Anthem, was offering plans on the state’s exchange.

It had nearly 40,000 customers at the end of 2014, far more than the 15,000 or so the co-op had predicted. That accounted for 80 percent of the marketplace.

The co-op had figured to lose $1.5 million in 2014, but it ended up earning a profit of $5.9 million which it pumped back into its operations.

Buoyed by its success, it branched out and began to offer plans in neighboring New Hampshire.

Sen. Ben Sasse, Nebraska Republican and leading critic of the co-ops, said if Maine’s program is “as good as it gets, things seem pretty bleak.”

“The only co-op operating in the black after the first year just announced it will stop accepting new exchange customers after Christmas,” he said. “It certainly seems like there is something seriously wrong with this program.”

Mr. Sasse has threatened to hold nominees to the Health and Human Services Department until he gets more information about what led to the co-ops’ demise.

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