The District will have one of the country’s smallest marketplaces — a distinction it shares with Vermont. It has among the fewest uninsured residents. The rollout of the District’s marketplace, DC Health Link, has been controversial at times because the D.C. Council voted in June to require that all small businesses buying policies in 2015 must go through the exchange. That was an effort to make the insurance pool as large as possible.
At least three categories of people will be targeted for enrollment. An estimated 42,000 people, or 7 percent of the District’s population, are uninsured. Nearly three-fourths live in Wards 1, 4, 5 and 7, according to the Urban Institute. Almost two-thirds are men and more than half are African American. A majority are younger than 35; most describe themselves as in good, very good or excellent health,
Another group — the estimated 25,000 people who buy insurance on their own, rather than getting it from employers — might use the exchange to try to find better deals, District officials said. The law also requires some congressional staff members to use the marketplaces, and that could produce an influx of young and healthy people in DC Health Link.
The District was one of the first jurisdictions to expand its Medicaid program in 2010, shortly after the Affordable Care Act was enacted. The expansion is the most generous in the region, covering adults up to twice the federal poverty level. That means an individual earning up to $22,980, or a family of four earning up to about $47,100, would be eligible.
Three insurers — Aetna, CareFirst BlueCross BlueShield and Kaiser Permanente — are offering 34 individual and family plans.
Unlike in Virginia and Maryland, insurers in the District will not charge higher rates for smokers.
Insurance officials gave these examples of potential premiums for District residents:
●A 27-year-old seeking to purchase the cheapest “bronze” policy could face a monthly premium of $124.05 for a CareFirst plan and up to $195.04 for an Aetna plan.
●A 55-year-old seeking to buy a “silver” policy could pay $423 for a CareFirst plan and up to $543 for an Aetna plan.
These estimates don’t include subsidies, which will cut the costs for many enrollees.
Businesses with 50 or fewer full-time employees that do not currently provide insurance to their employees but want to do so next year will be required to buy through the marketplace. (Small businesses that now offer insurance can renew their policies or change plans in 2014 without going through DC Health Link.)
People who need help can go online to www.dchealthlink.com or contact the marketplace call center at 855-532-5465, which provides assistance in several languages, including Spanish, Amharic, Vietnamese, Mandarin and Cantonese. The call center is open Monday through Friday, 8 a.m. to 6 p.m. Starting Oct. 1, it will be open seven days a week, 24 hours a day.
Health Link officials are teaming up with DC United, retailers and city recreation centers to encourage adults who don’t have insurance or have inadequate coverage to consider buying policies.
Almost three dozen community organizations were awarded $6.4 million in grants last month to train more than 150 guides to provide in-person help. The organizations include the DC Primary Care Association, La Clinica del Pueblo, Brown Memorial AME Church, Unity Healthcare, Whitman-Walker Clinic and Planned Parenthood of Metropolitan Washington.