D.C. Health Exchange

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By C.N. Staff Writer

slider2Back when President Barack Obama first campaigned to become president, he said that he wanted to make healthcare affordable to every American across the county.  Now into his second term, his vision for healthcare is beginning to take shape.  Under Section 3 of the Health Benefit Exchange Authority Establishment Act of 2011, the DC Health Benefit Exchange Authority (HBX) was established.  In accordance with the Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA), the mission of HBX is to implement a healthcare program that ensures access to quality and affordable healthcare for all District residents.

According to the exchange website (www.dchbx.com), the health care exchange program will enable individuals and small employers to find affordable and easier-to-understand health insurance and assist small employers in purchasing qualified health benefit plans for their employees. The exchange will facilitate the purchase of qualified health plans and assist individuals and groups to access programs, premium assistance tax credits and cost-sharing reductions.

On March 23, 2010 President Obama signed this bill into law, making it one of his most significant accomplishments, overhauling the healthcare industry since Medicare and Medicaid became law in 1965.  It aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, reduces the costs of healthcare for individuals and the government and requires most Americans to have healthcare by 2014.  A key provision of the act is that it stops healthcare companies from denying people coverage for pre-existing conditions, an issue many people across the county have been denied coverage for.

On June 28, 2012 the Supreme Court upheld the constitutionality of the bill in the case National Federation of Independent Business vs. Sebelius.  In the case, the state of Florida filed a lawsuit against the U.S. Department of Health and Human Services challenging the law.

Beginning October 1st, the DC Health Exchange will open, only, to individuals buying their own coverage and employees of DC small businesses (50 or less) and their family members.  Undocumented immigrants will not be allowed to purchase insurance through the exchange.  The Small Business Health Options Program (SHOP) Exchange is a program within the exchange designed to help small businesses offer healthcare options to will be limited to small businesses with 50 or fewer employees in 2014 but will expand to include businesses with up to 100 employees in 2016. Legislation approved by the DC City Council in June 2013 requires all small business owners to purchase coverage through the Exchange, as of 2015. SHOP employers may offer their employees all qualified health plans (or QHPs) offered by all issuer.  Employers must contribute at least 50% of the employee’s reference plan premium and must have a participation rate of two-thirds of qualified SHOP employees who do not have another source of coverage.

The exchange will hold its enrollment period from Oct. 1 through March 31. Under the law, most Americans are required to have insurance by Jan. 1, 2014, or face a fine, but officials have said those who are insured by April 1 will not receive a penalty. Insurance bought by mid-December will take effect Jan. 1; coverage bought by mid-March is effective April 1.

Under the federal law, each state can offer their version of the bill through a marketplace, exchange and offer in-person help.  D.C. chose the marketplace which  will target the 42,000 uninsured residents here.  According to the Urban Institute the majority of the uninsured live in Wards 1, 4,5 and 7, with more than half of this number Afrian-Americans.  The exchange has begun an aggressive outreach campaign to make sure these uninsured residents have the opportunity to opt into healthcare.  In mid-August they announced that Weber Shandwick was hired to help promote the exchange to the uninsured across the city.  A creative outreach, public relations, marketing, social media, and advertising strategy will take place to reach all those in need. The district also expects that Weber will reach out to both corporate entities and faith-based organizations to boost knowledge of the exchange among consumers.

Additionally, the exchange established fifteen Advisory Working Groups to engage consumer and community groups in implementing aspects of the Exchange. Each working group, chaired by a Board member and vice-chaired by a member of the Advisory Board, is tasked with a specific issue to address. Stakeholders attend working group meetings and contribute to developing recommendations for the Board.

Richard Sorian, ‎director of communications for education and outreach at the District of Columbia Health Benefit Exchange Authority, contends that “public understanding is growing.”  The DC exchange has also partnered with insurance brokers and organizations such as the Washington Chamber of Commerce, the Greater Washington Hispanic Chamber of Commerce, and the Restaurant Association of Metropolitan Washington, to connect with residents. A call center will also be open 24 hours starting October 1, and the group will also distribute printed materials to retail establishments, medical clinics, churches, and other organizations. Also recently announced the exchange has partnered with Major League Soccer franchise DC United to help promote health across the city.

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