Health Benefit Exchange Authority

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Consumer Information

Consumer Information

The District’s Health Benefit Exchange is an online marketplace [PDF] for District residents and small businesses to enroll in private or public health insurance options. Enrollment in the District’s Health Benefit Exchange will begin October 2013 with coverage starting January 1, 2014. The District’s Health Benefit Exchange will allow individuals and small businesses to compare health plans, to learn if they are eligible for tax credits for private insurance or health programs like DC Healthy Families/Medicaid and to enroll in a health plan that meets their needs.

For individuals and families who currently have health insurance, the District’s Health Benefit Exchange does not change your coverage or require you to change plans. However, if you are uninsured, looking for new coverage or want to compare policies, the District’s Health Benefit Exchange allows you to do so. In addition, other reforms found in the Patient Protection and Affordable Care Act (PPACA) could improve your existing health care coverage or provide you will tax credits to help pay for health insurance. The Act requires job-based health plans and new individual plans that no longer deny or exclude coverage to any child under age 19 based on health conditions, including babies born with health problems.

FamilyAlso, starting in 2014, if your income is less than the equivalent of approximately $88,000 for a family of four and you do not have access to affordable coverage either through your job, a family member’s job, or another government-sponsored program, you may be eligible to receive tax credits to help pay for insurance.   Even if you already have access to coverage, or you do not want subsidies, all District residents will be able to buy health insurance directly through the DC HBX, giving you access to better choices and lower prices similar to the access afforded to large businesses and members of Congress.

To help individuals and small business owners utilize the health insurance exchange, the District’s Health Benefit Exchange will include a Navigator Program.

Additionally, through advocacy, education and community outreach, the District’s Healthcare Ombudsman will ensure the safety and well-being of District consumers’ health care services.  If you have a complaint with a private health insurance provider, you can file a complaint with the Department of Insurance, Securities and Banking.

Additional Resources

On March 23, 2010, President Obama signed into law the Affordable Care Act (ACA). This new law represents the most significant overhaul of the health care system in decades. The ACA puts into place comprehensive reforms that improve access to affordable health coverage for everyone.  As a part of the ACA, each state is required to make available a health insurance exchange health insurance exchange for individuals and small businesses to compare and purchase health insurance plans. These exchanges can be established and managed by the state, by the federal government for the state, or through a federal-state partnership.

The District of Columbia has decided to establish its own exchange to ensure it meets the needs of District residents and small businesses. The District of Columbia’s Health Benefit Exchange (HBX) will provide an online marketplace for District residents and small businesses to access information and to enroll in private or public health insurance plans.

The Health Benefit Exchange Marketplace, Medicaid, and Other Aspects of the Health Care Law

As the implementation of the Affordable Care Act moves forward, many questions will be raised about the exchange marketplace, Medicaid, and other aspects of the health care law. The Centers for Medicare & Medicaid Services (CMS) has developed a Question and Answer document to address many of the questions.  We hope this information is helpful in providing you answers to many of your questions and concerns.

If you have additional questions, please send them to [email protected]

Internal Revenue Service

Under the Affordable Care Act, the federal government, state governments, insurers, employers, and individuals are given shared responsibility to reform and improve the availability, quality, and affordability of health insurance coverage in the United States. Click below for additional information.

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