In the contentious run-up to the passage of the Affordable Care Act, Congress passed a law to make nonprofit health insurance CO-OPs (formally known as Consumer Operated and Oriented Plans) a viable alternative to the public option. The idea was to create new competition in order to lower health insurance premiums and encourage innovation. Nearly two dozen such low-cost CO-OPs were launched in the wake of the ACA's passage; only four are in operation today.
In Death by Regulation, Dr. Peter L. Beilenson tells the story of a group of Maryland-based public health professionals who launched the Evergreen Health Cooperative, only to discover that the ACA law encouraging CO-OPs was a "plastic plant"—a piece of legislation created for optics but never intended to be functional. Over most of its four years of existence, Evergreen succeeded against all odds, prevailing over naysayers, big insurance companies, Congress, and its founders' naïveté. But in an ironic twist, it was bureaucratic hostility from the Centers for Medicare and Medicaid Services—the very Obama administration agency responsible for the CO-OPs—that led to their collective demise.
Beilenson traces the huge impact of seemingly small policy decisions on the work of his team and the people their CO-OP was built to serve. He recounts the excitement and satisfaction of launching such a valuable healthcare company, as well as the damage done to scores of employees and tens of thousands of satisfied healthcare customers when bureaucrats ran amok. The only book about these idealistic Obamacare CO-OPs and the obstacles they all faced, Death by Regulation offers an insider view of health policy and the reality of starting an insurance company from scratch.
|Publisher:||Johns Hopkins University Press|
|Sold by:||Barnes & Noble|
|Age Range:||18 Years|
About the Author
Peter L. Beilenson, MD, MPH, is the director of Sacramento County's Department of Health Services. The former CEO and president of the Evergreen Health Cooperative, he served as the health officer of Howard County, Maryland, from 2007 to 2012 and the health commissioner of Baltimore City from 1992 to 2005. He is the coauthor of Tapping into "The Wire": The Real Urban Crisis.
Table of Contents
Prologue: Sacramento, California, 1970
Part One. A CO-OP Is Launched
1. Creating Evergreen: March 2010 to March 2013
2. A Rocky Start: April 2013 to March 2014
3. Gaining Experience: April 2014 to June 2015
4. The Obstacles Pile Up: Summer 2015
5. Improving Fortune: November 2015 to March 2016
Part Two. Fighting the Good Fight
6. Evergreen Fights Back: April to June 2016
7. Preparing to Go to Court: June 2016
8. Evergreen Health Cooperative v. United States of America: July 2016
9. The Pursuit of Investors Begins: July to October 2016
10. Staying Alive: October 2016 000
11. Think Globally, Act Locally: October 2016 to January 2017
12. Ten Frenzied Days: January 2017
13. Finale: January to August 2017
Conclusion. A Dozen Lessons Learned
What People are Saying About This
"A solidly written, unique book that represents a 'professional diary' of Dr. Peter Beilenson, a well-known healthcare leader in the Baltimore region. A sophisticated and knowledgeable look at the history of Evergreen Health before and during its founding, and then after its premature demise."