DC Health Exchange Board Recommends Policies to Protect City Residents

DC Health Link was created and is governed by the DC Health Benefit Exchange Authority. (Courtesy of DC Health Benefit Exchange Authority)
DC Health Link was created and is governed by the DC Health Benefit Exchange Authority. (Courtesy of DC Health Benefit Exchange Authority)

The DC Health Benefit Exchange Authority Executive Board has unanimously adopted several recommendations from its Affordable Care Act Working Group to improve affordability and stability of private health insurance in D.C.

The recommendations, which would establish an individual responsibility requirement modeled on the federal requirement to maintain continuous insurance coverage, were shared earlier this week. They would make D.C. the first jurisdiction since the ACA was passed to adopt a continuous coverage requirement to keep private health insurance markets stable and make coverage more affordable for District residents with individual and family private coverage.

“The repeal of the Affordable Care Act (ACA) individual mandate will lead to an increase in premiums and loss of coverage for millions across the country and thousands here in the District,” Mayor Muriel Bowser wrote in her Jan. 10 charge to the DCBX board.

“While I continue to call on the federal government to expand access to health care coverage, it is clear that the current Congress and administration refuse to show leadership on this issue. I ask that the Health Benefit Exchange Authority Board reconvene the Affordable Care Act (ACA) Working Group, with the charge of recommending actions the District government should take to protect coverage gains and ensure affordable health care coverage for individuals and small businesses,” Bowser said. “I am requesting that the Working Group consider whether there are actions the District of Columbia should take in light of the repeal of the individual mandate.”

The DCHBX Board established the ACA Working Group to identify local policy options to strengthen the ACA protections. Recent federal government actions have jeopardized the stability of private health insurance. The DCHBX ACA Working Group began its work in the summer of 2017, initially met ten times and voted unanimously for several market stability and affordability recommendations.

Bowser asked DCHBX last month to reconvene the ACA Working Group to reexamine and amend the initial policy recommendations after the individual responsibility requirement was repealed in the federal tax overhaul of 2017. The group met eight times this year and unanimously recommended to the DCHBX Board to add a District individual responsibility requirement to their initial recommendations.

“In the District, we want to make health coverage affordable and accessible,” said Jodi Kwarciany, Health Policy Analyst at the DC Fiscal Policy Institute and Vice Chair of the DCHBX ACA Working Group. “Policies like these will really help District residents in our individual marketplace and ensure a robust and stable marketplace.”

Local policy recommendations include:

• A District individual responsibility requirement that is modeled on the federal requirement with changes to enhance protections for District residents;

• A local reinsurance program to help make premiums more affordable for the District’s 18,000 residents with private individual health insurance; and

• A local supplement to the federal premium subsidy to increase the affordability of health insurance for the approximately 1,000 residents who are currently subsidy eligible.

Together, these recommendations help ensure a stable individual health insurance market and more affordable private health insurance.

Leighton Ku, DCHBX Executive Board Member and chair of the ACA Working Group, added that D. C.’s uninsured rate of less than 4 percent is at its lowest point in city history.

“Thanks to the Affordable Care Act and the efforts from DC Health Link, the Bowser administration, DC Council, and partners throughout DC government and our community,” Ku said. “It is important to build on this success.”

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