One of the vaunt­ed advances of the ACA, in response to pub­lic request, was the cre­ation of a pub­lic plan option to com­pete with pri­vate insur­ers offer­ing cov­er­age in the exchanges.   These new Con­sumer Oper­at­ed and Ori­ent­ed Plans (COOP) are slip­ping into insol­ven­cy. All but one lost mon­ey in 2014 and one failed spec­tac­u­lar­ly with the loss of 20% of all COOP enrollees nation­wide. Final­ly, many of the remain­ing COOPs appear to be set­ting arti­fi­cial­ly low pre­mi­ums to gain mar­ket share, los­ing mon­ey tax­pay­ers are expect­ed to cov­er. There are, of course, many rea­sons, and a lot of fin­ger point­ing, but the fact remains that they are com­pet­ing for the same peo­ple as the pri­vate insur­ance car­ri­ers with a lot less cap­i­tal­iza­tion and recog­ni­tion and, in the end, insuf­fi­cient enroll­ment to ade­quate­ly spread risk that rose almost as soon as it began, as claims ran high­er than expect­ed. In the end, all the COOPs have bor­rowed more than $75 mil­lion in start­up funds that must be repaid with­in five years along with $2 bil­lion in low inter­est loans that are due with­in 15 years…and then the fed­er­al gov­ern­ment, through HHS, pro­vid­ed emer­gency fund­ing of $355 mil­lion in the last four months of 2014.