Most of the 23 Consumer Operated and Oriented Plans that provided health insurance in 2014 had not met their initial enrollment and profitability projections by the end of the year, according to a report released yesterday by the Department of Health and Human Services’ Office of Inspector General. The Affordable Care Act authorized HHS to make startup and solvency loans to these nonprofit health insurance issuers, who projected their annual enrollment and net income on the loan application. Enrollment in 13 of the CO-OPs was considerably lower than projected and 21 had incurred net losses by the end of 2014, OIG said. Year-end net income data were not available for the Iowa/Nebraska CO-OP, as the Iowa insurance commissioner took control of the CO-OP last December due to financial concerns and the insurer was liquidated in March. The report recommends that HHS continue to place underperforming CO-OPs on enhanced oversight or corrective action plans as required, and work with state insurance regulators to identify and correct underperforming CO-OPS.