Welcome!
On behalf of the Mayor’s Health Reform Implementation Committee, I am pleased to provide you with the first edition of our new e-newsletter, “For Your Benefit,” a monthly report of DC Health Reform news, views, and activities.
“For Your Benefit” will provide you with news and information on our effort to improve health and health care in the District through implementation of the federal Affordable Care Act. In addition, “For Your Benefit” will highlight related efforts to improve access and delivery of social service benefits to District residents.
This newsletter is “For Your Benefit,” so feel free to send us any suggestions or questions we can address to make this newsletter more beneficial to you. I look forward to updating you on all that we are doing to make health reform a reality in the District of Columbia.
Regards,
Wayne Turnage
Director, Department of Health Care Finance
Chair, Health Reform Implementation Committee
Health Reform Moves Ahead in the District
Since the passage of the historic Affordable Care Act (ACA) in March 2010, District leadership has fully embraced health care reform and has moved rapidly to achieve full implementation of the new health care law.
The District implemented some health care reform provisions sooner than the federal law required. The Council of the District of Columbia passed the “Health Insurance Rate Making Improvement and Reform Act of 2010,” which provided coverage for dependents up to age 26 under their parents’ insurance and passed the “Health Insurance Rate Making Improvement and Reform Amendment Act of 2010,” which mandated that a certain percentage of premium dollars had to be spent on medical care.
In addition, the District acted to expand Medicaid coverage for childless adults under age 65 with incomes up to 133% of the federal poverty level earlier than the ACA requires and moved 38,000 District residents from the DC Health Care Alliance Program to Medicaid.
The most monumental reforms, however, are those that are being planned for 2013 and 2014. The Mayor’s Health Reform Implementation Committee (HRIC), a multi-agency coordinating board, is developing and planning for the implementation of reforms, such as establishing the District’s new Health Benefit Exchange, which includes an online insurance marketplace, updating and improving Medicaid eligibility processes, and exploring innovative health care delivery models.
To date, District agencies have received millions of dollars in ACA grant funds. These include more than $9 million awarded to the Department of Health Care Finance (DHCF) to support the planning and establishment of the District’s Health Benefit Exchange; more than $150,000 awarded for the Office of the Health Care Ombudsman and Bill of Rights, and a $240,000 planning grant to the Department of Health and the Department of Mental Health to develop a Health Homes pilot.
Each month, “For Your Benefit” will update you on the progress the District is making on planning and implementing important health reform initiatives.
What is the HRIC?
The Affordable Care Act (ACA) will have a far reaching impact within the District. The responsibility for keeping the Mayor advised on the implementation of the ACA and making sure that health reform implementation activities in the District are carried out successfully is the role of the Health Reform Implementation Committee (HRIC).
In 2011, Mayor Vincent C. Gray appointed Wayne Turnage, Director of the DC Department of Health Care Finance (DHCF), to be the Chair of the HRIC. William White, Commissioner of the DC Department of Insurance, Securities and Banking (DISB) and Dr. Mohammad N. Akhter, Director of the DC Department of Health (DOH), were named Co-Chairs of the HRIC. Stephen T. Baron, Director of the DC Department of Mental Health (DMH); Laura L. Nuss, Director of the DC Department of Disability Services (DDS); and David A. Berns, Director of the DC Department of Human Services (DHS), also are members of the HRIC.
The HRIC is organized and operates through the following six standing subcommittees:
1) Insurance, chaired by DISB - Responsible for issues related to the insurance market in the District, including those associated with the District’s Health Benefit Exchange
2) Medicaid Expansion and Eligibility, chaired by DHS - Responsible for issues related to Medicaid expansion, as well as eligibility and enrollment for existing and new insurance affordability programs in the District
3) Health Delivery System, chaired by DOH - Responsible for issues related to integration of prevention into the delivery system, patient safety, quality of care improvement, health care delivery options, and manpower training
4) Communications, chaired by DHCF - Responsible for supporting communications efforts related to health reform in the District
5) Exchange Operations, chaired by DISB and DHCF - Responsible for issues related to the District’s Health Benefit Exchange operations, including the Navigator Program and financial sustainability
6) Information Technology, chaired by DHS - Responsible for the District’s new health and human services IT system, including a new consolidated eligibility system and all functions for the District’s Health Benefit Exchange
The Subcommittees meet monthly, and meetings are open to the public. In some instances, some subcommittees host additional working group meetings, which meet more frequently, and also are open to the public. See the calendar at the end of this newsletter for the dates, times and locations of the subcommittee meetings in May. Click here to view the meeting minutes on the District's Health Reform website.
Within the Department of Health Care Finance, the Health Care Reform and Innovation Administration (HCRIA) provides support to the HRIC and helps to oversee health reform initiatives in the District.
Information about all the HRIC meetings and opportunities for public participation is on the health reform calendar. We welcome your involvement and interest in our efforts to implement health reform in the District.
Have a Question about Health Reform?
Check out the Frequently Asked Questions on the health reform website.
Don't see your question? Send us an email at [email protected] with the question, and we will try to address it in future newsletters.
Insurance Proposal Vote at May 17 HRIC Meeting
The HRIC Insurance Subcommittee recently put forth formal recommendations for what the District’s insurance marketplace should look like when the District’s Health Benefit Exchange is launched in 2014.
The recommendations must be approved by the HRIC Executive Board before they are forwarded to Mayor Gray for consideration.
The HRIC is scheduled to vote on the recommendations at the May 17 HRIC meeting. Time will be provided at the meeting for additional public comments on the recommendations. The Insurance Subcommittee’s report, discussing the recommendations and comments received from stakeholders, is available on the health reform website. Additional comments can be submitted online until May 11.
HRIC Insurance Subcommittee Insurance Marketplace Recommendations:
1) Plans offered in the DC Health Benefit Exchange (DC HBX) insurance marketplace must meet minimum requirements set forth by the ACA for qualified health plans (QHPs) as well as any additional requirements set forth by the HRIC and/or the DC HBX Authority.
2) The DC HBX insurance marketplace should be the sole marketplace in the District of Columbia for the purchase of individual and small group health insurance plans.
3) The risk pools of the small group market and individual markets in the DC HBX insurance marketplace should be merged into one single risk pool.
4) Small group size in the District of Columbia should be defined as 2-100 as opposed to the current practice of 2-50.
5) The District of Columbia should opt into the federally administered risk adjustment and reinsurance programs for the DC HBX insurance marketplace.
Did You Know...?
..…that the District of Columbia has one of the lowest rates of uninsured residents in the entire nation? Only about 7% of all District residents are not covered by any type of public or private health insurance.
Help Us Build a New Consumer Assistance Program in the District
Through the DC Health Benefit Exchange (DC HBX), both individual consumers and small businesses will be able to get quality, affordable private health insurance plans that fit their health care needs. The ACA requires that Exchanges establish “Navigator Programs” to help consumers and small businesses use these new marketplaces. The ACA provides guidelines for setting up Navigator Programs, however, many decisions about Navigators are left up to the states.
In addition to providing access to health insurance, the DC HBX will be used to determine eligibility and provide access to Medicaid and other social services. The District must determine what responsibilities, if any, it wants Navigators to have for those additional programs.
Since individual consumers and small businesses will use the Exchange, questions arise whether there should be different types of Navigators who specialize in each type of customer. Or, should all Navigators be required to help all users of the Exchange? What role should insurance brokers play in the Exchange? These are just some of the questions that require answers to ensure a user-friendly, objective and informative Navigator Program for District residents and small businesses.
We are seeking input from District residents and stakeholders on how the District Navigator Program should be set up. Follow this link to access the online survey. https://www.surveymonkey.com/s/3Y5NZB8
Comments can also be sent directly to [email protected].
Note: The deadline for the Navigator Survey is extended to May 11 to allow additional time for e-newsletter readers to participate. We want to hear from you!
Information Technology Update
In addition to building the DC Health Benefit Exchange (DC HBX), it is the District’s intent to replace its existing health and human services eligibility system with a new platform for Medicaid, TANF, and its other federal and local health and human services programs. This will allow seamless coordination between DC HBX insurance assistance programs and existing health and human services programs. The District will partner with a system implementation vendor to develop the new system by issuing a request for proposal in late June 2012. A draft of the statement of work will be posted on the health reform website this month.
Join the District’s Health Reform Team
District of Columbia health and human services agencies are seeking candidates to work on health care reform and the District’s new health care and human services eligibility and enrollment solution.
Through the DC Access Project (DCAP), the District of Columbia is breaking new ground with its implementation of the Affordable Care Act, with a goal of improving access to services for all District residents through a new health care and human services solution, which includes the District’s Health Benefit Exchange (DC HBX).
DCAP is an exciting two to three year effort where team members work to develop individual and family focused benefits policies, modernize major service delivery systems, and establish an DC HBX as required in the Affordable Care Act.
To help make this vision a reality, several positions are now open at the DC Department of Human Services and Department of Health Care Finance. Eligible candidates will have experience and knowledge related to Medicaid eligibility, health insurance, human services, consumer engagement, and/or implementation of new IT systems.
If you are interested in the following positions in the Department of Health Care Finance, please send your cover letter and resume to [email protected].
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Medicaid Program Manager
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Medicaid Policy Project Manager
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Ombudsman Consumer Assistance Project Manager
If you are interested in the following positions in the Department of Human Services, please send your cover letter and resume to [email protected].
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Program Analyst
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Management Analyst
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IT Project Manager
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IT Specialist (Mainframe)
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IT Specialist (Application Software)
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IT Specialist (Database Manager)
These positions will also be posted on the DC Department of Human Resources website (www.DCHR.dc.gov) in the coming weeks.
May Health Reform Calendar
Wednesday, May 2, 2:00 PM
Communications Subcommittee Meeting
John A. Wilson Building, 1350 Pennsylvania Avenue NW, Room 306
Tuesday, May 8, 11:00 AM
Insurance Subcommittee Meeting
Department of Insurance, Securities and Banking, 810 First Street NE, 7th Floor
Tuesday, May 8, 2:00 PM
Exchange Operations Subcommittee Meeting
Department of Health Care Finance, 899 North Capitol Street NE, Room 6130
Tuesday, May 8, 11:00 AM
Insurance Subcommittee Meeting
Department of Insurance, Securities and Banking, 810 First Street NE, 7th Floor
Tuesday, May 8, 2:00 PM
Exchange Operations Subcommittee Meeting
Department of Health Care Finance, 899 North Capitol Street NE, Room 6130
Wednesday, May 9, 3:00 PM
Information Technology Subcommittee Meeting
Department of Human Services, 64 New York Avenue NE, 6th Floor Large Conference Room
Thursday, May 10, 10:00 AM
Medicaid Eligibility & Enrollment Subcommittee Meeting
Department of Human Services, 645 H Street NE, 5th Floor Conference Room
Thursday, May 10, 2:00 PM
Health Services Delivery Subcommittee Meeting
Department of Health, 899 North Capitol Street NE, Room 535
Friday, May 11, 5:00 PM
Comments due on Navigator Program Survey
Feedback due on Insurance Marketplace Recommendations
Monday, May 14, 3:00 PM
Insurance Subcommittee, Plan Management Work Group Meeting
Department of Insurance, Securities and Banking, 810 First Street NE, 7th Floor
Tuesday, May 15, 11:00 AM
Insurance Subcommittee, SHOP Working Group Meeting
Department of Insurance, Securities and Banking, 810 First Street NE, 7th Floor
Thursday, May 17, 2:00 PM
Health Reform Implementation Committee Executive Committee Meeting
Department of Health Care Finance, 899 North Capitol Street NE, Room 6100
Subcommittees
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Communications Subcommittee: Responsible for supporting communications efforts related to health reform in the District
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Exchange Operation Subcommittee: Responsible for issues related to the District’s Health Benefit Exchange operations, including the Navigator program and financial sustainability.
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Health Delivery System Subcommittee: Responsible for issues related to integration of prevention into the delivery system, patient safety, quality of care improvement, health care delivery options, and manpower training.
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Insurance Subcommittee: Responsible for issues related to the insurance market in the District, including those associated with the District’s Health Benefit Exchange.
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IT Subcommittee: Responsible for the District’s new health and human services IT system, including a new consolidated eligibility system and all functions for the District’s Health Benefit Exchange.
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Medicaid Expansion and Eligibility Subcommittee: Responsible for issues related to Medicaid expansion, as well as eligibility and enrollment for existing and new insurance affordability programs in the District.
Produced by The Crider Group
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