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District of Columbia health insurance

Special enrollment period available to people who didn't know about DC's individual mandate

Health insurance in Washington, DC

DC’s health insurance marketplace

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

How hard is the District of Columbia fighting to preserve the Affordable Care Act’s provisions? Compare to other state efforts.

In Washington, DC, coverage in the individual and small-group health insurance markets is available only through the state-run exchange: DC Health Link. There is not an off-exchange option.

The federal government reduced the duration of individual market open enrollment to just over six weeks, starting in 2017.  But DC was one of three exchanges that opted to keep the duration of open enrollment at three months.

Special enrollment period for people who didn’t know about DC’s individual mandate

Open enrollment for 2020 coverage in DC was scheduled to end on January 31, but the District added a few extra days at the start of February as well. Although the enrollment period has ended, DC Health Link is also offering a special enrollment period for residents who weren’t aware of the District’s individual mandate before filing their 2019 tax return.

Read our overview of the DC health insurance marketplace.

DC enrollment in qualified health plans

As of early 2020, there were 15,247 people with individual coverage through DC Health Link, plus 79,809 people with employer-sponsored plans through DC Health Link’s small business (SHOP) exchange. Members of Congress and their staffers have coverage through DC Health Link’s SHOP exchange, as do all small businesses with group health coverage in the District, as there are no off-exchange options available.

Read more about DC’s marketplace.

Medicaid in Washington, DC

The District of Columbia, along with 35 states, has expanded Medicaid coverage under the ACA. The state decided early on to participate in the expansion ahead of schedule, beginning enrollment in 2011. And DC’s Medicaid eligibility guidelines are among the nation’s most generous, with coverage for adults extending to at least 210 percent of the poverty level (versus 138 percent in most states).

Read more about Medicaid expansion in DC.

Short-term health insurance in DC

The District of Columbia has enacted legislation that limits the duration of short-term health plans to three months and prohibits renewals. In addition, DC law prevents short-term plans from excluding pre-existing conditions or basing eligibility on medical history.

Read more about short-term health insurance in DC.

How has Obamacare helped DC?

The District of Columbia’s uninsured rate stood at 6.7 percent in 2013, which was well below the national average. By 2018, the uninsured rate in DC had dropped to 3.2 percent; only Massachusetts had a lower uninsured rate. The ACA has been instrumental in the reduction of the uninsured rate, along with various reforms that the District has made.

District of Columbia and the Affordable Care Act

While a delegate represents the District of Columbia in the U.S. House of Representative, that delegate does not vote on proposed bills. The District of Columbia is not represented in the U.S. Senate. Accordingly, the District of Columbia is not “on record” for the 2010 House and Senate votes establishing the Affordable Care Act.

The District of Columbia City Council established a state-run health insurance marketplace under the ACA. The legislation establishing the District of Columbia Health Benefit Exchange Authority was signed into law by Mayor Vincent Gray (D) in January 2012. The bill was also subject to review by the U.S. Congress. This is the typical process for legislation in the District of Columbia, and Congress rarely rejects laws passed by the District of Columbia.

Medicare enrollment in DC

By the end of 2019, there were 94,340 people enrolled in Medicare, about 13 percent of the District’s total population. Nationally, about 17 percent of the total population is enrolled in Medicare.

Learn more about Medicare in the District of Columbia, including details about Medicare Advantage plans, Medicare Part D plans, and Medigap plans.

Washington DC health insurance resources

Healthcare legislation in DC