Cooperatives or insurance cooperatives were proposed in the Senate as an alternative to a proposed government plan or public option. The cooperatives, which would have been structured as non-profits and owned by their members, would offer a network of health care providers or contract out for medical services.
The concept championed by some Democrats would provide “seed money” for the cooperatives, which would then be sustained by customer premiums. The final version of the ACA included Consumer Oriented and Operated Plans (CO-OPs), which became available in 24 states in 2014. Read this Commonwealth Fund history of health cooperatives.