HELENA, Mont. (AP) — Montana’s health care co-op, one of America’s few remaining alternatives to traditional health insurance, resumed accepting new enrollees Sunday after it voluntarily pulled itself from the state’s insurance marketplace in December.

The insurer took the nine-month hiatus from enrolling new members in the exchange created by President Barack Obama’s Affordable Care Act to boost its financial reserves and keep it from the same fate that has befallen failed co-ops across the country.

The program was among about two dozen privately run health co-ops that sprang up across the country following the 2010 passage of the Obama administration’s health care law. They provided medical coverage with premiums far lower than plans offered by traditional health insurance companies.

But within two years, half of the programs folded — undermined by financial miscalculations and the volatility of the insurance marketplace. (Iowa-based CoOpportunity Health folded in 2015.) Just four remain — in Montana, Wisconsin, Maine and New Mexico. Last week, Massachusetts placed Minuteman Health co-op in receivership.

“When all the other co-ops were going down, we were losing money, too,” said Jerry Dworak, the Montana Health Co-op’s CEO. “Thankfully, we’ve turned things around.”

This year, the co-op is projecting $28 million in profits, after weathering a string of losses. It lost about $6 million in its first year and more than $40 million the following year, Dworak said.

So confident is the co-op about its financial health that Dworak said it has the capacity to absorb all 64,000 Montanans who buy their insurance through the state’s exchange. It now enrolls about 20,000 people who purchase individual plans on the exchange. Blue Cross and PacificSource, the two other providers on the state’s exchange, have nearly 32,000 and 12,000 enrollees, respectively.

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