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Four of the 11 remaining health cooperatives set up under the Affordable Care Act are still seeing tepid enrollment, according to a report by federal investigators, in another sign such insurance startups are on shaky footing despite more than $1 billion in federal loans. The cooperatives were launched under the health law to provide affordable insurance and infuse competition into the market. Twelve of the 23 co-ops that got off the ground have closed as a result of financial troubles. The Obama administration is seeking to recoup about $1.2 billion in federal loans to the co-ops that have closed. (Armour, 3/16)

State officials and consumer advocates are reminding Massachusetts residents with subsidized health insurance coverage to file their tax returns before April 19 -- or risk losing their federal tax credits. For the first time this year, 174,000 people in Massachusetts who receive tax credits to offset the cost of their health insurance must file a tax form to prove they were eligible for the credits. Those who don’t file could be forced to pay back their tax credits or lose eligibility for credits in future years. Tax credits are available to help individuals and families with low or moderate income pay for health coverage. (Dayal McCluskey, 3/16)

Health insurance is no guarantee against financial hardship, according to a national poll by NPR, the Robert Wood Johnson Foundation and the Harvard T. H. Chan School of Public Health. "People are financially overwhelmed in lives that are working OK — they have financing for everything else in their life but they can't deal with this large medical bill," says Robert Blendon, a professor of health policy and political analysis at the Harvard Chan School. (Mack, 3/17)