A race against time: can CO-OPs and provider start-ups survive in the health insurance marketplaces?

> The Affordable Care Act's state and federal health insurance marketplaces, designed to provide affordable insurance coverage to individuals and small groups, are proving hostile territory to new market entrants. Efforts to inject competition into the marketplaces are being challenged by the wide-scale withdrawal o consumer-operated and oriented plans (CO-OPs). Meanwhile, premiums appear likely to increase for consumers as plans seek to balance medical losses. Flaws in the "Three R's" (reinsurance, risk corridors, and risk-adjustment) program are viewed as a threat to the survival of CO-OPs and start-ups.