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DC Health Link, Local Health Plans and Advocacy Groups Say Financial Sustainability Plan for the District’s Health Insurance Marketplace Is an Issue of Fairness

Monday, May 5, 2014
Supporters state all those who benefit should pay their fair share to support the new health insurance marketplace.

The District of Columbia Council is scheduled to consider a measure tomorrow, Tuesday, May 6, that would establish a sustainable local funding source to support operations of DC Health Link, the District’s new health insurance marketplace established under the Affordable Care Act.

DC Health Link has had a successful launch. Since the marketplace opened for business on October 1, 2013, DC Health Link has enrolled 44,833 people in quality, affordable coverage. The number of those who signed up for health coverage includes District residents who enrolled in private health plans and in Medicaid, as well as people with coverage through their employer.

So far, operations of DC Health Link have been funded with federal implementation grants, but those funds are set to expire later this year. Both federal and District law require the new marketplace to become financially self-sufficient by January 1, 2015. 

After accepting consensus recommendations from a stakeholder advisory working group, representing consumers, health insurers, brokers, small businesses and others, that considered a wide range of funding options, the Health Benefit Exchange Authority adopted a policy of a broad-based assessment on health carriers as the most fair way to pay for operations, while minimizing the impact on premiums.

While the plan is supported by a number of health insurance companies who offer insurance to DC residents, a small number of insurers – primarily those providing supplemental insurance – oppose the assessment plan.

“Our position is that this is an issue of basic fairness,” said Mila Kofman, J.D., executive director of the DC Health Benefit Exchange Authority. “Insurers who benefit and profit – not the taxpayers – should pay.”

Insurers selling supplemental coverage directly benefit from an expanded number of District residents who now have comprehensive health insurance.  People with health insurance are more likely to purchase supplemental insurance if they fear hospitalization costs or worry about incurring other major medical expenses beyond the scope of their policies.  Many supplemental products are only sold to people with comprehensive insurance.  It is only fair that insurance companies that benefit financially from the new marketplace should support its ongoing operation.

In a letter to the City Council dated April 10, 2014, nearly 20 community health and advocacy organizations agreed, urging the Council to adopt an assessment. They wrote, “We believe the broad-based health carrier assessment is the best tool for funding the exchange’s operations while maintaining affordability for consumers and businesses, and we hope that you support the proposed rule as it moves forward.”  Signatories to the letter include:  the American Cancer Society Cancer Action Network; the American Heart and Stroke Association of the Mid-Atlantic; Autism Speaks; the DC Chapter of the National Organization for Women; the DC Coalition on Long Term Care; the DC Fiscal Policy Institute; Families USA; Family and Medical Counseling Services; the Greater Washington Society for Clinical Social Work; the Hemophilia Association of the Capital Area; the Hemophilia Federation of America; La Clínica del Pueblo; the Legal Aid Society of the District of Columbia; Mary’s Center; the Metropolitan Washington Council, AFL-CIO; Miriam's Kitchen; the National Capital Chapter of the National Multiple Sclerosis Society; the National Women’s Law Center and Whitman-Walker Health.

In addition to these groups, health plans and others supporting this policy include Kaiser Permanente, Aetna, National Multiple Sclerosis, DC Chamber of Commerce, Restaurant Association Metropolitan Washington, Greater Washington Hispanic Chamber of Commerce, DC Behavioral Health Association, The Young Invincibles, Leadership Council for Healthy Communities, and the Capital City Area Health Education Center.

“DC Health Link was created by our community to serve our community, and it isn’t reasonable to expect someone else to foot the bill when these insurers profit.  No one should be able to duck their fair share,” said Kofman.

For more information about the District’s new health insurance marketplace, visit DCHealthLink.com.

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