The legislation endorsed by three House committees includes language allowing a modest expansion of the co-op experiment, and the idea has broader support in the Senate, where an effort to get a more centrist bill out of the Finance Committee will take on added urgency after Labor Day.

Asked why there isn’t broader support for co-ops, Oemichen, who once worked as an aide in the House of Representatives, said it is a simple question of familiarity.

“There just are not a lot of people on the Hill who understand what a cooperative is and what a cooperative can do,” he said.

Conrad has suggested the government could provide about $6 billion in funding to get more co-ops up and running, and he and his allies in the debate believe this approach will be more successful and have more support politically than a pure government-run health insurance options.

Some, though, have questioned whether a model that works well in rural areas can be copied in urban or suburban areas, or have raised questions about the formulas that would be necessary to offer subsidies to low-income Americans without health insurance. Others have warned that regulating health co-ops would create new bureaucracy.

From his perspective on the farm in rural Wisconsin, Topel says it makes sense to him to try something with a proven track record before launching a sweeping new government program.

“I just can’t see, being a private businessman, how the government can do anything more efficiently,” he said. “As an owner of the company, you’re going to make sure you get the best rates and the lowest rates, and I’m not sure the government can do that. But certainly the co-op is an option, and I think a much better option than a government option would be.