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A new breed of health insurers created under the Affordable Care Act — representing one of the government’s most innovative attempts in decades to foster better coverage — is on shaky financial ground in many of the 23 states where the plans began. ... But in recent months, nearly half of the unorthodox start-ups have been told by federal regulators that their finances, enrollment or business model need to shape up. The Centers for Medicare and Medicaid Services (CMS), which oversees the health-care law, recently sent warning letters to 11 of the “co-ops,” as they’re known. The agency placed them on “enhanced oversight” or required them to produce a plan of “corrective action,” or both, according to federal figures not previously made public. Several have been notified in the past two weeks. (Goldstein, 10/10)

The largest private provider of health insurance policies on Kynect, Kentucky's health insurance exchange, is going out of business. The Louisville-based Kentucky Health Cooperative Inc. announced Friday that it will end current memberships on Dec. 31 and will not add new members because of financial problems. It will not offer health insurance plans on Kynect when open enrollment for 2016 coverage starts on Nov. 1. The cooperative has about 51,000 members in all 120 Kentucky counties. (Brammer, 10/9)

The Kentucky Health Cooperative, a nonprofit, government-subsidized insurance group aimed at offering consumers more choices in health coverage under the Affordable Care Act, will stop offering health plans at the end of this year. ... The state Cabinet for Health and Family Services said the state Department of Insurance will be working with customers to ensure coverage continues through this year when most of the cooperative policies expire. (Yetter, 10/9)

The Department of Health and Human Services says that it recognizes that the low payments to insurers could have raised financial concerns for some insurers, and that as start-ups, not all co-ops would succeed. The Obama administration said when making the risk corridor announcement earlier this month that the low payments could cause “isolated solvency and liquidity challenges” for a small number of insurers. The Kentucky co-op is the fifth to close, following New York’s co-op last month. (Sullivan, 10/9)