New Mexico Health Connections, the nonprofit co-op insurance company formed under the Affordable Care Act, is selling its small group and commercial business to a for-profit company under a restructuring plan that will create a new insurance company that will be able to go after business the struggling nonprofit couldn’t.
...The Washington, D.C.-based Evolent will acquire NMHC’s 22,000 commercial members. NMHC will continue to exist with a few employees and presumably continue to sell individual policies on the New Mexico Health Insurance Exchange. NMHC has 10,000 individual members through the insurance exchange.
...Hickey told ABQ Free Press that the deal will allow the new firm to go after business that NMHC couldn’t, things like Medicare Advantage, federal employees and, eventually, Medicaid. It also gives the new firm capital reserves that NMHC didn’t have, he added.
Now, since LoL went belly-up mid-year regardless, obviously even those massive rate hikes weren't enough to save them, so the question is, what would have happened if LoL had gotten their nominal increases as requested?
When the dust settled, there were 11 Co-Ops left standing, but most of them were still on pretty shaky ground, with all but a handful placed under "enhanced oversight" by their states (and I have to admit that the term sounds an awful lot like a euphamism, a la "enhanced interrogation technique").
Throughout last September and October, I chronicled the dominos-like downfall of a dozen ACA-created Co-Op insurance carriers. They tumbled, one by one, as a result of a perfect storm of problems, some of which dated back to the final version of the ACA which was signed into law; others which cropped up along the way:
Conrad's plan called for $10 billion of government grants distributed among nonprofit, member-owned health insurance startups. The money came with few restrictions. Competing against big for-profit insurers is difficult, Conrad said. The co-ops needed as much freedom as possible to ensure their survival.
Ever since I laid into Congressional Republicans on Friday for deliberately sabotaging the funding program for the ACA's CO-OP Risk Corridor program last December, several people have correctly pointed out that, while having federal funds cut for this program cut off was certainly a major factor in at least one of the CO-OPs going under (the Kentucky Health CO-OP), there was a different policy change--made nearly 2 years ago--which may also contributed to their financial woes (and which may have played a role in some of the other 4 CO-OPs which fell apart prior to the risk corridor debacle hitting home a week or so ago).
The Office of the Inspector General released a big report today which confirms what most healthcare/ACA observers have known for awhile now: The CO-OP organizations established by the ACA across 2 dozen states to help increase competition and keep the private, for-profit insurance companies (somewhat) honest...haven't been doing very well overall.