DC Health Benefit Exchange Authority Mila Kofman,

Transcript:DC Health Benefit Exchange Authority Mila Kofman,:
DC Health Benefit Exchange Authority Mila Kofman, J.D., Executive Director HBX Performance Oversight FY24-25 Oversight Hearing DC Council Committee on Health Chairperson Councilmember Henderson 1/29/25 Background Federal Landscape and Inflation Reduction Act Open Enrollment Implementation of Expanding Access to Fertility Treatment Amendment Act of 2023 HealthCare4ChildCare Social Justice and Health Equity to address disparities in health outcomes 2 HBX is responsible for DC Health Link – DC’s Affordable Care Act online health insurance marketplace Last state to start IT build, 1 of 4 state marketplaces opened for business on time (& stayed open) Oct 1, 2013 Funded through assessment on health carriers In 2024 celebrated 10 years of success DC Health Link: ACA State-Based Online Health Insurance Marketplace 2025 DC Health Link Successful ACA State-Based Marketplace NEAR UNIVERSAL COVERAGE: 97+% of DC residents covered Cut uninsured rate by half since DC Health Link opened for business DC ranks #2 in U.S. for lowest uninsured Cover nearly 100,000 people (private health insurance) Cover 5,300+ District small businesses and non-profits Have 900+ DC Health Link brokers providing free help to customers Responsible for $670+ million in annual premiums 4 Federal Landscape: Inflation Reduction Act The American Rescue Plan Act/Inflation Reduction Act (ARPA/IRA) lowered premiums for more than 24 million people with health insurance through ACA marketplaces, such as DC Health Link, and, for the first time, made middle class families eligible for lower premiums. Middle-class families, self-employed and small business owners who buy coverage on their own have lower premiums now. If Congress takes this away, expect huge premium hikes and millions of people to lose their health insurance coverage. 5 Inflation Reduction Act: Health insurance benefits to DC residents Premiums as low as $13/month for quality health insurance through DC Health Link. 68% of people with lower premiums are self-employed or small business owners who buy coverage on their own (DC Health Link Individual & Family Marketplace). 1 in 4 residents covered on DC Health Link’s Individual & Family Marketplace gets lower monthly premiums. Residents save on average $724/month in lower premiums. Residents 55 and older save on average $1,135/month on their health insurance premium. Residents save over $12 million in annual lower premiums (Source: 2022 IRS data). 6 Window shopping October 16 to October 31: preview 2025 health plans and rates before Nov 1. 2025: 27 health plans from CareFirst BCBS and Kaiser Permanente. Essential Plans: No deductibles for primary