In 2010, the Affordable Care Act (ACA) was signed into federal law by President Obama. The ACA requires each state in the U.S. to develop its own health insurance exchange to create a versatile marketplace where individuals and business owners can gain access to health coverage. In 2012, the District of Columbia Health Benefit Exchange Authority was established. The passing of this law was instrumental in developing the DC Health Link. The DC Health Link was created by the DC Health Benefit Exchange Authority and they continue to oversee the plans and their operators.
What is the DC Health Link?
The DC Health Link is a comprehensive health insurance marketplace designed for the District of Columbia. In DC, health insurance coverage in individual and small group markets is currently only available through the DC Health Link. As of January 10, 2014, the DC Health Link had enrolled more than 3,646 individuals in individual or family health insurance plans. This number includes many members of Congress. As of February 1, 2016, the DC marketplace had enrolled approximately 74 percent of all eligible residents in DC.
Improvements to the DC Health Link
Over the past year, we have seen numerous updates to the DC Health Link. After reviewing shortcomings in the marketplace that were cited in 2016, improvements have been made to bridge the gaps and create a more attractive marketplace for individuals and business owners. In early 2017, only three exchanges including DC Health Link, Healthcare.gov, and Connect for Health Colorado offered all the decision-support tools that are considered the gold standard of informed consumer choice. These tools include an integrated drug directory, integrated provider directory, and an out-of-pocket cost calculator. The DC Health Link provides all three of these essential consumer tools.
The DC Health Link also ranked first overall for best-in-class with a score of 92 out of 100. The exchange ranked best-in-class in six of the eight primary features. While a report conducted on the exchanges showed much improvement, there were still some recommendations made to improve the consumer’s shopping experience. It was recommended to allow states more flexibility to maintain their exchanges, as well as encourage public exchanges to compete by allowing people to use their premium tax credits from the public exchanges. It was also recommended to enhance the federal data hub to act as a resource for all private and public exchanges.
Open Enrollment for 2018 Coverage
Americans had until December 15th to obtain mandatory health coverage through exchanges under Obamacare or the Affordable Care Act. Open enrollment for the upcoming year planned to run from November 1 to December 15, a period of just over six weeks. This is roughly half the amount of time offered during the last few DC marketplace enrollment periods. This new schedule was announced in April of 2017. However, in June the DC Health Link reported that it would give people an additional month to comply. Open enrollment for 2018 will now follow its original schedule which started on November 1, 2017 and ends on January 31, 2018.
DC Health Link Insurance Options
The DC Health Link currently offers individual health insurance plans from Kaiser and CareFirst Blue Cross Blue Shield. Note that PPOs and HMOs are two individual entities. Small group health insurance plans are currently from several different insurers, including Kaiser, CareFirst, Aetna, and UnitedHealthcare. Like with the individual market, some insurers in the small group market offer healthcare plans in two individual entities. The initial deadline for insurers in DC to file plans and related rates for 2018 coverage was May 1, 2017.
While many individuals in the U.S. are experiencing a decline in plan choices, you can expect to see more plans on the DC Health Link in 2018. DC’s insurers are set to offer additional plans in the individual market in the next year than in the current year, with 26 total plans available in 2018 compared to just 20 in 2017. In the small group market, the number of plans will remain steady at 151 insurance plans available from several insurers. If you will be choosing health insurance from the individual market, take your time to review the new plans.
Rate Increases in the Individual Market
You can expect some rate increases in the individual market which were approved in October. CareFirst HMO, or CareFirst Blue Choice, currently has 6,176 members as of 2017 and will see a rate increase of 19.6 percent. CareFirst PPO, or GHMSI, currently has 7,795 members as of 2017 and will also see a rate increase of 19.6 percent. Kaiser, which currently has 2,484 members as of 2017, will see a rate increase of 13 percent. In the small group market, several insurers’ proposals for new rates were approved, while some were altered. Rate increases can be seen by CareFirst, Kaiser, Aetna, and UnitedHealthcare.
Minimal Impact from CSR
The Trump Administration’s choice to eliminate funding for CSR or cost-sharing reductions throughout the country has had a major effect on premiums for the upcoming year. Many states have already filed new rates based on the belief that the funding would no longer be available. Others who failed to do so are now scrambling to alter their filings to include these extra costs. However, the effect of CSR funding in DC is minimal. Kaiser and CareFirst both proposed their rates for 2018 with the belief that CSR funding would still be available.
The Affordable Care Act has allowed thousands of District residents to obtain secure, affordable, and high-quality health insurance. The DC Health Link aims to maintain the benefits offered by the Act and move towards providing members with full coverage. Currently, more than 96 percent of District residents are covered by health insurance, resulting in some of the lowest uninsured rates in the country. If you are an employer in search of health insurance for your employees, the Business Benefits Group (BBG) can help. Our team of business professionals will work with you to develop an affordable and advantageous benefits package.