What exactly contribued to the decline of Iowa's CoOportunity Health's, the nation's second-largest consumer operated and oriented plan? The CO-OP had to pay much more in medical bills than previously anticipated, NPR reported. CoOportunity Health's pool was not only larger than expected; it was also sicker. Many sick residents opted for CoOportunity Health after learning Wellmark would not offer plans on Iowa's exchange. "It was always going to be a challenging market to try to reach," Peter Damiano, director of the University of Iowa's public policy center, told NPR. On top of that, the whole idea of co-ops was "relatively new and experimental." Article