A new wave of failures among ObamaCare’s nonprofit health insurers is disrupting coverage for thousands of enrollees. Four ObamaCare co-ops have failed due to financial problems since the beginning of the year, the latest trouble for the struggling program. Just seven of the original 23 co-ops now remain.

All that failure has been pricey. Taxpayers are out $1.7 billion in federal loans that these co-ops will never pay back. Mismanagement, mis-pricing, low enrollment and high enrollment have all been blamed for the co-ops’ failure. The Daily Caller found that 18 of the 23 CO-OPs were paying top executives up to half a million dollars a year.

But Obamacare itself is responsible for the most recent co-op bankruptcies. As part of its effort to “fix” the individual insurance market, Obamacare banned insurers from pricing coverage based on risk. Instead, they have to take all comers and charge each one no more than three times what they charge anyone else. To make the math for this scheme work, Obamacare created a series of cross-subsidies called “risk adjustment.” Insurers who attracted less expensive, healthier-than-average enrollees were supposed to pay into a fund that would redistribute money to those who enrolled costlier, sicker-than-average patients.

Several co-ops ended up facing big “risk adjustment” bills – even though they were losing money. HealthyCT, for example, had to grapple with a $13.4 million bill, which immediately made the plan financially unstable. Oregon’s Health co-op – which lost $18 million last year – had hoped to get $5 million from the risk adjustment program. Instead, it received a $900,000 bill. Unsurprisingly, it’s closed up shop. The Land of Lincoln co-op was told it owed almost $32 million. It can’t afford to pay that sum after losing nearly $91 million in 2015.

The latest round of failures poses an even thornier problem than earlier cases because enrollees’ coverage is now being disrupted in the middle of the year. That can increase patients’ out of pocket costs and make it harder to keep the same doctors. Some theorized that ObabaCare would remove marginal claims from workers’ compensation systems. Now the reverse may be the case instead, an increase in marginal or questionable claims.

In Illinois, Oregon and Ohio, a combined total of about 92,000 people are being forced to find a new plan. A co-op in a fourth state, Connecticut, will last until the end of the year. Now there’s a similar situation in three other states.

Now, just seven co-ops – Wisconsin’s Common Ground Healthcare Cooperative; Maryland’s Evergreen Health Cooperative; Maine Community Health Options; Massachusetts’ Minuteman Health; Montana Health Cooperative; New Mexico Health Connections; and Health Republic Insurance of New Jersey – remain. Those seven all lost money last year – and may yet go out of business before the calendar turns to 2017.

The Centers for Medicare and Medicaid Services awarded $2.4 billion to 23 co-ops that were eventually created. However, the majority of the co-ops struggled to turn a profit, resulting in the collapse of 16 of the original 23 that received $1.5 billion in startup and solvency loans. Now, with just seven co-ops remaining, regulatory filings show that many ended 2015 in the red.

For the seven co-ops left to survive, they will have to increase the cost of their premiums, especially since many of the nonprofit insurers kept the costs down during the beginning years of Obamacare’s implementation to attract customers.

Since Obamacare’s implementation, it’s not only co-ops that have struggled to make money. Oscar, a startup insurance company serving New York and New Jersey that launched in 2012, lost $105 million in 2015.

Additionally, UnitedHealth Group CEO Stephen Hemsley said the company expects to lose more than $1 billion from its exchange business – $650 million in 2016 and $475 million in 2015. The company, which is the nation’s largest insurer, decided to pull out of at least 26 of the 34 exchanges it offered coverage on last year after warning the marketplaces were a risky investment.

And Health Care Service Corporation, which operates Blue Cross Blue Shield plans in five states, reported losses totaling $65.9 million in 2015. The company lost $281.9 million in 2014.