In the Patient Protection and Affordable Care Act (PPACA), the federal government pledged $3.8 billion in grants and loans to assist in the establishment of nonprofit, member-run health insurance issuers—Consumer Operated and Oriented Plans (CO-OPs). As the implementation of exchanges gets closer and becomes a reality, CO-OPs may have a role in changing the health insurance paradigm.

This briefing paper provides background on CO-OPs, reviews activity since the enactment of the PPACA, and identifies challenges and opportunities for potential CO-OPs.