Washington, D.C., residents will have fewer options next year when they go to purchase individual health insurance plans on the District’s health insurance exchange, but its executive director insists there are no problems with the marketplace.
Those who seek plans other than that offered by health maintenance organizations (HMO) will have only one plan to choose from, with proposed increases to premiums to rise by double digits.
Recently, Aetna started sending city residents letters telling them that health insurance plans purchased through D.C. Health Link will terminate at the end of this year.
CareFirst will now be the only health insurer to District residents preferred provider organization (PPO) plans, which afford some freedom for policyholders to choose doctors and hospitals.
Mila Kofman
In its letter, Aetna said it “determined we can no longer meet the needs of our customers while remaining competitive in the market.”
D.C. Health Link, the District’s health insurance marketplace, was created two years ago under a mandate of President Obama‘s signature legislation, the Affordable Care Act.
CareFirst has proposed rate increases for its PPO plans ranging from less than 3% to more than 17%. Industry analysts characterized those increases as moderate, given an average increase of about 7 percent expected nationwide.
The number of health plans offered on the District’s health insurance exchange has been cut by about half from what it was when D.C. Health Link opened under a cloud of delays and problems two years ago. There will no only be 162 plans.
The District has struggled as one of the smallest independent health insurance exchanges created under the ACA. Many self-employed, under-employed and retired workers have expressed concern about the dramatic drop in the number of plans and flexibility, wondering if they will be able to afford coverage in 2016.
Speaking to the Washington Post, Mila Kofman, director of the exchange, said the reported changes are not a sign of trouble with the marketplace, but instead show that a smaller number of plans means that carriers have done a better job at providing for the needs of District residents.
“When you have products when there’s not a whole lot of interest to buy, that’s the market telling the carrier what they are selling, people can’t afford,” Kofman told the Post. “So in terms of competition, it’s not a loss.” she said.
Aetna will continue to offer plans on the exchange through employers, including Congress. Federal lawmakers and their staff employees make up more than 16,100 of the nearly 19,800 people who buy insurance on the exchange through employers in the District. A slightly larger group — more than 23,000 people — have been insured through individual plans purchased on the marketplace.
