From Premium Increases to Failing Co-ops: An Obamacare Checkup

PURPOSE:

• To assess the Centers for Medicare and Medicaid Services’ (CMS) plans to protect consumers and safeguard billions in taxpayer dollars.
• To examine the viability of the Consumer Operated and Oriented Plan (CO-OP) Program, and other concerns related to the Patient Protection and Affordable Care Act (PPACA).

BACKGROUND:

• Under the PPACA, CMS awarded $2.4 billion in loans to help create CO-OPs.
• 14 of 23 CO-OPs have closed, disrupting insurance for over 800,000 consumers.
• More than half of the nine remaining CO-OPs are on Enhanced Oversight Plans and/or Corrective Action Plans.
• The Exchanges have also been plagued by systemic problems, including call center glitches, website failures, software problems, deficient processes for determining eligibility, and lower than expected enrollment numbers.