By Carla Anderson
February 28, 2014
DC Health Link announced enrollment data on Feb. 10: 5,090 people have purchased individual or family coverage, 12,659 enrolled through the small-business, or SHOP, marketplace, and 8,451 people qualified for Medicaid. In total 26,180 have enrolled in coverage since open enrollment began on Oct. 1.
The Washington Post reported that nearly all the signups through the small-business, or SHOP, exchange are members of Congress or Congressional staffers. DC Health Link is the designated marketplace for members of Congress and their official office staff, following a rule issued by the Office of Personal Management, which oversees benefits for federal employees. Congress and their staffers are eligible to continue receiving the federal employer contribution toward their coverage so long as they select a plan through DC Health Link.
Of those purchasing individual or family coverage, 44 percent are between the ages of 18 and 34. That figure is above the 40 percent threshold often cited as the level needed to keep premiums stable.
Enrollment for private insurance in 2014 continues through March 31. Policies purchased by the 15th of the month will be effective the first day of the following month. Individuals who remain uninsured after March may face a tax penalty of $95 or one percent of income, whichever is greater. Enrollment through the SHOP exchange and for Medicaid or the Children’s Health Insurance Program continues throughout the year.
The District of Columbia was an early adopter in moving to implement a health insurance exchange. The Health Reform Implementation Committee (HRIC), formed at the direction of Mayor Vincent Gray, issued its final recommendations in October 2011. The D.C. City Council adopted many of the committee’s recommendations and passed a bill to create the District of Columbia Health Benefit Exchange Authority, which Gray signed it into law in January 2012. The District of Columbia received federal approval to operate a state-based exchange in December 2012. In June 2013, the exchange was rebranded as DC Health Link.
While planning and implementation of the DC exchange was less contentious than in many of the states, one decision by the D.C. Exchange Authority drew strong criticism and pushback. In October 2012, the Authority announced that small employers must use the exchange for health insurance purchases. Exchange officials said the mandate was necessary given the small population in the District. Without requiring small employers to participate, officials said, enrollment simply wouldn’t be high enough to sustain exchange operations. Small business protested the decision. While the board seemed intent on maintaining the requirement, it did vote to allow some businesses until 2016 to comply. The D.C. City Council in June 2013 unanimously passed temporary legislation supporting the mandate. That legislation is set to expire in October 2014; the council will likely consider permanent legislation in the first half of 2014.
Aetna, CareFirst BlueCross BlueShield, and Kaiser Permanente are selling policies for individuals and families on DC Health Link. Those insurers plus UnitedHealthCare are selling small-business policies. The insurers are offering 34 options for individuals and families and 267 options for small businesses.
According to a report released by HHS, the average cost for a bronze plan — the lowest-cost option — in the District of Columbia is $204 a month. The national average for a bronze policy is $249 a month.
There are 42,000 uninsured people in D.C, which is about 7 percent of the population. DC consumers and small businesses can work with a “DC Health Link Assister” or a broker to purchase insurance through the marketplace. The DC Health Link website explains the difference between the two roles and includes a search function for locating either an assister or a broker.
DC Health Link
Implementing Health Insurance Exchanges: District of Columbia
The Henry J. Kaiser Family Foundation overview of the District of Columbia’s progress toward creating a state health insurance exchange.
Let your District of Columbia governor and legislators know how you feel about the state’s proposed health insurance exchange.