Created by the Affordable Care Act, the CO-OP (Consumer Operated and Oriented Plan) program was designed to help create nonprofit, member-controlled health insurance plans that would offer ACA-compliant policies in the individual and small business markets.
Twenty-four states had CO-OP plans available in their exchanges starting in October 2013. But nearly all of them have since closed. As of 2022, there are just three CO-OPs still operational:
CO-OPs were initially supposed to get $10 billion in grant money, but that ended up being changed to $6 billion in loans (with fairly short repayment timelines). CO-OPs also fell victim to the risk corridors fiasco in far greater numbers than long-established health insurance companies. And the ACA’s risk adjustment program was also challenging for CO-OPs.
Read more about CO-OP health insurance plans.