By Carla Anderson
April 10, 2014
Consistent with the federal marketplace and most state-run exchanges, DC Health Link extended the enrollment deadline. DC Health Link officials announced consumers who need help applying or who have who have started an application online now have until April 15 to complete their enrollment.
People who get married or divorced, change jobs, have a child or experience another qualifying event may be eligible for a special enrollment period to purchase commercial insurance before the next open enrollment period (which begins Nov. 15, 2014, for coverage in 2015). Enrollment through the SHOP exchange and for Medicaid or the Children’s Health Insurance Program continues throughout the year.
Individuals who remain uninsured may face a tax penalty of $95 or one percent of income, whichever is greater.
DC Health Link announced its latest figures on April 1: 9,838 people have purchased individual or family coverage, 12,907 enrolled through the small-business, or SHOP, marketplace, and 17,489 people qualified for Medicaid. In total 40,234 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.
At 46 percent, the District leads the nation in the percentage of people ages 18 to 34 signing up for private health plans. Nationally, the figure is 25 percent. Forty percent is the threshold often cited as the level needed to keep premiums stable. The selection of health plans is quite evenly spread across the metal levels in the District. Twenty-nine percent of health plan enrollees selected bronze plans, 25 percent selected silver plans, 22 percent selected gold plans, and 20 percent selected platinum plans. An additional four percent selected catastrophic plans, which are available only to those under 30 or those who qualify for a hardship exemption. Nationally, enrollment is heavily skewed to silver plans, with 63 percent of enrollees selecting these mid-level plans.
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.
Prior to the launch of the marketplace, there were 42,000 uninsured people in D.C (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.