The 8 Obamacare Co-Ops Most Likely To Fail This Year
Eight of the 11 remaining Obamacare health insurance co-ops appear likely to fail this year, according to an analysis of financial documents obtained by The Daily Caller News Foundation.
Twelve of the original 23 federally-financed co-ops have already collapsed. The co-op program was funded with $2.5 billion in 2010.
“In general, there’s not a turnaround in sight. The same problems that plagued them before are continuing,” Thomas P. Miller, senior fellow at the American Enterprise Institute who previously served as the senior health economist for the congressional Joint Economic Committee, told TheDCNF.
Obamacare advocates hoped the tax-funded non-profit co-ops would successfully compete with for-profit commercial insurance companies and drive down healthcare costs and eventually become permanent fixtures in the marketplace.
State insurance regulators are already liquidating in the 12 states where the co-ops already have closed their doors.
In some states like New York, hospitals and doctors are facing hundreds of millions in losses that will not be covered by the assets of the failed co-op, Health Republic of New York.
Data compiled by TheDCNF based on the co-op 2015 annual reports suggest eight are likely to default and only four of them will be in business by year’s end.
The co-op documents obtained by TheDCNF were annual reports filed before state insurance regulators. The reports must accurately depict the financial health of the co-ops and are current through the end of calendar year 2015. The annual reports became available to the public in mid-March.
The Department of Financial Services of New York is also conducting an official investigation into Health Republic, alleging the co-op did not accurately describe its financial condition to regulators.
Earlier this year, Mandy Cohen, a top official at the Centers for Medicare and Medicaid Services (CMS), told Congress eight co-ops are facing special scrutiny because of their poor financial statuses.
She said an “enhanced oversight” program is in place for some troubled co-ops and others are operating under a federally imposed “corrective action plan.”
Although CMS officials have steadfastly refused to identify the eight “at risk” co-ops, the annual reports clearly identify those facing grave financial problems. Data shows last year all 11 co-ops lost money and the red ink also afflicted the four “healthy” co-ops that may survive.
The co-ops with the most losses in 2015 were in Massachusetts, Oregon, Ohio, Connecticut, Montana, Wisconsin, Illinois and New Mexico. All eight burned through about 50 percent of their total assets in 2015. The assets were supposed to last for 20 years under the terms of the federal funding program.
The troubled Oregon co-op is the Health Republic Insurance Company. It was founded by Sara Horowitz, a long-time New York liberal political activist and former colleague of President Barack Obama. The Oregon co-op reported its losses were greater than its overall assets. At the end of last year, its total assets were $21 million but net losses were $29 million.
Horowitz’s New York co-op imploded last year and was the largest Obamacare co-op failure in the nation, losing $365 million in federal funds.
Last February, the Oregon co-op filed a $5 billion class action lawsuit against the federal government, saying Washington owes the co-ops additional funds beyond the $2.5 billion outlay.
“We don’t have anything to lose, given our current status,” Oregon’s CEO Dawn Bonder said when she filed the lawsuit.
The co-ops aimed to provide affordable health insurance for people earning approximately 400 percent of the federal poverty level. But many of the failing co-ops also paid lavish salaries to their executives.
In Illinois, the Land of Lincoln Health Mutual Health Insurance Company reported its assets were $107 million and net losses were $91 million. Illinois has already announced it will no longer accept new customers.
The Illinois co-op is not transparent about its expenses, however. When other expenses are tabulated, its financial condition could be worse than those on its books.
Land of Lincoln’s sponsor is the Metropolitan Chicago Health Council (MCHC). In its annual report, Land of Lincoln states the salary for CEO Daniel Yunker was only $83,000.
MCHC reports his real income is $460,000 more. The same for Kevin Scanlon, who works for nothing according to their annual report, but received a whopping $916,000 in compensation.
Land of Lincoln also paid an unexplained $55,000 in “dues” to MCHC.
Like Land of Lincoln, Connecticut’s HealthCT suffered major losses. The co-op reported $112 million in assets, but its net change in cash was negative $55 million. It missed enrollment projections when it sought 25,000 new customers and attracted less than 8,000.
HealthCT’s commitment to serve low-income families did not deter its executives from getting outsized private sector salaries, with CEO Kenneth Lalime getting $387,000 in 2014. Six other co-op employees received salaries exceeding $200,000.
In Massachusetts, Minuteman Health co-op executives reported assets were $95 million, but net losses were $43 million. Minuteman projected it needed 40,000 enrollees to “break even” but in 2014 it only garnered 14,000 customers.
Minuteman’s CEO Thomas Policelli was paid $435,874 in salary and compensation in 2013. Three other co-op executives were paid between $315,000 and $324,000.
Like Illinois, Connecticut and Massachusetts, the most challenged co-ops saw net income losses hover at about 50 percent of total assets.
The Montana Health Cooperative in 2014 had $67 million in assets but suffered net income losses of $41 million.
In Ohio, Coordinated Health Mutual was barred from operating in 2014 because it failed to properly file its documents before the insurance regulators. The co-op’s executives reported in 2015 its assets were $108 million but net losses last year topped $79 million.
Wisconsin’s Common Ground Healthcare Cooperative reported $37 million in losses in 2014, half of its $74 million in total assets.
New Mexico Health Connections had $61 million in assets and a net loss of $23 million.
Co-ops with better balance sheets in 2015 were not completely out of trouble. Maryland’s Evergreen co-op saw its original assets of $65 million shrink to $37 million in 2015 and net cash on hand was negative $5.5 million.
Horowitz also operates a third co-op in New Jersey that does not appear to be at risk. The co-op, Health Republic of New Jersey, reported its assets at $140 million and its net losses at only $18 million.
New Mexico Health Connectors also appeared stable with $61 million, only $16 million down from its $77 million in federal loan money. Still, the net loss in 2015 was negative $22 million, a rapid burn rate.
Maine has been a standout from all of the co-ops and in 2014 was the only nonprofit to operate in the black. Still, there were warning signs. Of its $168 million in assets, it recorded a net loss of $74 million.
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