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DC Health Exchange Authority Executive Board Approves Plan for a New Health Exchange Marketplace

Wednesday, October 3, 2012
Exchange to be sole marketplace to offer affordable quality health insurance for individuals and small businesses.

Today the DC Health Benefit Exchange Board, appointed to operate the District’s health benefit exchange, voted unanimously to endorse recommendations from the Insurance Working Committee on how the Exchange will operate.

The federal Affordable Care Act requires each state and the District to set up an Exchange where individuals and owners of small businesses can buy health insurance. The Exchange will provide high-quality, affordable health coverage, and allow consumers to easily compare prices and policies online.

“We have made a great start toward creating an exchange the District can be most proud of,” said Dr. Mohammad N. Akhter, chairman of the Health Benefit Exchange board. “I look forward to creating an institution that aspires to ensure no Washingtonian will go without insurance.”

The District’s population is relatively small compared to most states – around 600,000 – and the District agencies and their consultants who have worked on this proposal since the Affordable Care Act passed in 2010 devised a plan that considers the unique characteristics of this market.

The provisions the Committee recommended and the Health Benefit Exchange Executive Board approved Wednesday were:

  • That the exchange be the sole health insurance marketplace for individuals and small businesses. This will help sustain the exchange in this unusually small market.
  • To maintain the current definition of small business as one to 50 employees instead of one to 100.
  • That health insurance plans meeting minimum requirements set forth by the ACA for qualified health plans, as well as any additional requirements set forth by the Exchange Authority, can be offered in the DC Exchange.  This will preserve and expand current health insurance plan choices for District residents.
  • That the risk pools for the small businesses and individual buyers of insurance should be merged into a single pool to make quality, affordable health coverage seamlessly available to all District residents irrespective of employment status.
  • To opt into the federally administered risk adjustment and reinsurance programs for the Exchange’s market.

Because the District started early creating an exchange; persisted despite the challenge to the Affordable Care Act in the U.S. Supreme Court; and solicited the advice and input from a wide range of experts and stakeholders, the District is in good shape to meet a November deadline, when it must show the federal government it is making progress toward Exchange implementation.

In addition, the US Department of Health and Human Services last week awarded a Level Two Establishment Grant for $73 million to the District to develop the IT infrastructure, operations, education, and outreach activities of the District’s Exchange through 2014.  This grant award demonstrates the Districts considerable progress in implementing a state-based Exchange for District residents.

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For more information on health reform in the District, visit healthreform.dc.gov.  Follow us on twitter at @dchbx.