A D.C. board is set on Wednesday to consider requiring individuals and small-business owners in the District to purchase their health insurance through the newly minted health exchange it oversees.
The D.C. Health Benefit Exchange was set up this year as the city's health insurance marketplace as a part of the federal health care reform that requires coverage of all Americans by 2014. The exchange's chair, Dr. Mohammad Akhter, has said that the requirement is necessary -- even for those who already have insurance -- in order to maintain a large pool of clients in the health exchange so that the exchange can negotiate rates with insurers.
The requirement would affect small businesses with 100 employees or fewer -- or about one-quarter of the District's estimated 323,000 people with employer-sponsored health insurance -- according to a report from consultant Mercer LLC. Including the 7 percent of the city's 600,000 population that has no insurance at all, the mandate would apply to approximately 123,000 residents.
But the requirement, which is up for discussion and a potential vote on the exchange board's Wednesday agenda, has businesses worried they'll end up with a different insurer and higher rates. Employers can stick with their current health insurer if that provider opts in to D.C.'s exchange. Under the proposal, however, employers lose their right to negotiate a rate directly with their insurer and must let the health exchange do it for them.
Max Farrow, spokesman for the D.C. Chamber of Commerce, said the chamber's membership has expressed reservations about the proposed requirement.
"The chamber has been working diligently to ensure that the government provides access for all, in whatever form they desire, and we are optimistic that the plan will be amended to allow for affordable and more accessible health care both within and outside of the exchange," Farrow said.
He added that the organization wants more than one health insurer to choose from within the exchange and is pushing regulations that "clearly allow for employers to seek health benefits outside of the exchange no matter the size of their business, as the Affordable Care Act intended."
Neither Akhter nor at-large Councilman David Catania, who chairs the council's Committee on Health, was available to comment Tuesday.
If the board does pass the requirements, the D.C. Council would then be required to create legislation putting them into effect. That means public hearings, and more opportunities for opponents to have their say.
"We at the chamber will continue to watch the process closely to see that the new rules that are enacted make it viable for all businesses in the District to succeed and thrive," said Farrow.