As an activist, Joel Albers has spent years campaigning for universal health care. And disparaging health insurance companies as bureaucratic and monopolistic.

But now, Albers, who is also a Twin Cities pharmacist, has decided to go into competition with what he calls the "big four profit-driven HMOs" in Minnesota. Albers and his group, the Universal Health Care Action Network of Minnesota, announced plans last week to create Co-op Care, a cooperative health insurance plan that would be owned and operated by its members, much like a food co-op.

Many would argue that Minnesota already has one of the nation's largest health insurance co-ops: HealthPartners has been held up as a national model because it's both nonprofit and governed by members.

But Albers insists that Co-op Care would be different. In concept, it would work like a mini-version of universal health insurance: one giant "risk pool," which means that everyone essentially pays the same rates and gets the same benefits. Or, as he's fond of saying, "Everybody in, nobody out."

The goal is to have the co-op up and running by this fall and offer it as an option on the state's health insurance exchange.

Albers said his group, which meets in a church basement, came up with the idea about a year and a half ago. They were intrigued, he said, because the law that created Obamacare also set up a seed fund to help start new insurance cooperatives.

Unfortunately, Albers said, most of those funds were cut in the fiscal cliff deal. That left Co-op Care, which had applied for $6 million in low-interest start-up loans, in limbo. Now it's hoping the Minnesota Legislature will step in and ensure those loans.

Albers admits that members would have a limited choice of clinics and hospitals under the plan; the details are still to be worked out. Still, he believes that the idea would appeal to many Minnesotans. "We would be accountable just the way the food co-ops are accountable," he said. "People trust them."