A government watchdog overseeing the Department of Health and Human Services delivered the grim financial state of nearly all of the co-ops—that collectively received $2.4 billion—created under Obamacare several months ago.

Now, following the collapse of six of the 23 that launched in 2013, the co-ops, or consumer oriented and operated plans, face an uphill battle to solidify themselves as competitors in the health insurance market.