District of Columbia health insurance exchange
More than 12,000 accounts created through DC Health Link
By Carla Anderson
October 28, 2013
Three weeks into open enrollment, DC Health Link reported activity on its website. More than 12,000 people and 426 small businesses have created accounts. Nearly 1,900 individuals and families have completed applications, and 321 have selected a health plan.
While DC Health Link launched smoothly on Oct. 1, one important function was not available. Mila Kofman, executive director of DC Health Link, announced Sept. 25 that online calculations to determine eligibility for Medicaid or tax credits will be delayed until November. Until then, consumers can still submit their applications online, and staff will determine eligibility manually.
In mid-October, DC Health Link announced that about 200 “DC Health Link Assisters” had completed training and were ready to assist consumers with the enrollment process. DC consumers and small businesses can also work with 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.
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 been 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 say the mandate is necessary given the small population in the District. Without requiring small employers to participate, officials say, enrollment simply won’t be high enough to sustain exchange operations. Small business protested the decision. While the board seems intent on maintaining the requirement, it did vote to allow some businesses until 2016 to comply. The D.C. City Council in June 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.
In May 2013, the D.C. Exchange Authority announced that 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 the U.S. Department of Health and Human Services (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.
Members of Congress and their official office staff will use DC Health Link, 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.
District of Columbia health insurance exchange links
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.