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Health Insurance in Washington DC

This page is dedicated to helping customers quickly find health insurance resources in the District of Columbia. Here, you will find information regarding the many types of health insurance coverage available. You can find the basics of the Washington, DC health insurance marketplace and upcoming open enrollment period, a brief overview of Medicaid expansion in the District of Columbia, and a quick look at short-term health insurance availability in DC.

Health Insurance Marketplace in DC

In Washington, DC, coverage in the individual and small-group health insurance markets is offered only through the DC-run health insurance marketplace: DC Health Link. There is not an off-exchange choice.

The federal government lowered the individual market’s duration of open enrollment to just over six weeks, starting in 2017. But Washington, DC, was one of three exchanges that opted to keep open enrollment duration at three months.

As of early 2020, there were 15,247 persons with individual coverage through DC Health Link, plus 79,809 individuals with employer-sponsored plans through DC Health Link’s small business (SHOP) exchange. Members of Congress and their team have coverage through DC Health Link’s SHOP exchange, as do all small businesses with group health plans in the District, as there are no off-exchange choices available.

Open Enrollment Period and Dates in Washington, DC

Open health insurance enrollment period and dates in Washington, DC

Open enrollment in DC for 2020 health insurance coverage was scheduled to end on January 31, but the District added a few more days at the start of February as well.

Even though the open enrollment period has ended, DC Health Link is also providing a special enrollment period for residents who were not aware of the District’s individual mandate before filing their 2019 tax returns.

Washington, DC, Medicaid expansion

The District of Columbia, along with 35 states, has expanded Medicaid coverage under the Affordable Care Act. The state decided early on to take part in the Medicaid expansion ahead of schedule, start enrollment in 2011. Moreover, DC’s Medicaid eligibility guidelines are among the nation’s most generous, with Medicaid coverage for people extending to at least 210 percent of the poverty level (versus 138 percent in many states).

Short-Term Health Insurance in Washington DC

The District of Columbia has enacted legislation that limits the period of short-term health insurance plans to three months and prohibits renewals. Additionally, DC law prevents short-term health insurance coverage from excluding existing conditions or basing medical history eligibility.

How Obamacare Has Helped DC Residents

Washington, DC uninsured rate stood at 6.7 percent in 2013, which was well below the national average. By 2018, the uninsured rate in District Columbia had dropped to 3.2 percent; only Massachusetts had a lower uninsured rate. The Affordable Care Act has been crucial in the reduction of the uninsured rate, along with different reforms that the District has made

District of Columbia and the Affordable Care Act

DC has a state-run health insurance marketplace under the Affordable Care Act.

While a delegate represents the District of Columbia in the United States House of Representatives, that delegate does not vote on proposed bills. The District of Columbia is not represented in the United States Senate. Hence, the District of Columbia is not “on record” for the 2010 House and Senate votes establishing the ACA.

The District of Columbia City Council established a state-run health insurance marketplace under the Affordable Care Act. The law establishing the District of Columbia Health Benefit Exchange Authority was enacted into law by Mayor Vincent Gray (D) in January 2012. The bill was also subject to review by the United States Congress. This is the typical process for legislation in the District of Columbia, and Congress hardly rejects laws passed by the District of Columbia.

Medicare Coverage and Enrollment in Washington, DC

By the end of 2019, there were 94,340 DC people with Medicare enrollment, around 13 percent of the District’s total population. Nationally, about 17 percent of the total populace is enrolled in Medicare.

Resources and References:

• Health Insurance Coverage in the U.S.
• The Affordable Care Act