“First, several plans are already heading in the right direction. For example, Maine’s CO-OP has both high enrollment—it enrolled over 80 percent of marketplace enrollees in 2014—and favorable net income. These initial successes allowed the company to expand into New Hampshire and drop its rates slightly for 2015. Others, in spite of initial setbacks, are proving nimble in response to market pressures by cutting premiums, signing small-business customers outside of the marketplaces, and emphasizing new care delivery models such as patient-centered medical homes.
“Second, as start-ups, it shouldn’t be surprising that many will run at a loss initially. Some may only need bridge loans to overcome temporary cash flow problems.”