When it passed Congress in 2010, the Affordable Care Act offered substantial financial support to create nonprofit health-insurance plans. Today 11 of the 23 such regional Consumer Operated and Oriented Plans have failed—seven since the beginning of October. They’ve collapsed despite federal startup loans totaling more than $1.1 billion. These loans will likely never be fully repaid, while insurers and consumers will be on the hook for any unpaid claims left behind by failed insurers.