WASHINGTON — The latest round of open enrollment begins Nov. 15 for the District of Columbia’s locally run health insurance marketplace. Here are some things to know about the state of health insurance in the District.


More than 30,000 people have signed up to buy insurance through the District’s private and small-business exchanges since they launched last October, and nearly 33,000 more have been found eligible for Medicaid after applying for insurance through the exchange. Before the federal health care overhaul took effect, the District had about 36,000 uninsured residents, or roughly 6 percent of the population — one of the lowest rates of uninsured in the country.

Exchange officials say surveys show roughly half of those who’ve bought insurance were previously uninsured. While officials aren’t setting numerical goals for the next round of open enrollment, they hope to continue reducing the rate of uninsured residents.

“We think, just based on our population, who we enrolled … we made a significant debt in the District’s uninsured rate,” said Mila Kofman, executive director of the D.C. Health Benefits Exchange Authority.


The exchange’s budget for the current fiscal year is $28 million, funded mostly through a broad tax on all insurance policies issued in the District. The tax was collected for the first time in September, and while it didn’t bring in enough revenue to cover the exchange’s entire budget, it wasn’t expected to. Federal grants covered the rest.

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The American Council of Life Insurers challenged the tax in a federal lawsuit, arguing that the District unfairly taxes products that can’t be purchased on the exchange in order to fund its operation. Exchange officials said Friday that a federal judge had dismissed the suit.

The District’s exchange faces funding challenges in part because of the small population of the nation’s capital, which has 646,000 residents. A study conducted for Kaiser Health News pegged the District’s exchange as the nation’s second-costliest per enrollee, trailing only Hawaii’s.


The exchange’s website has added new features that officials hope will improve the user experience. One is that if people like their plan, they will be renewed automatically — no need to call or fill out a form online. Also, people who get married or have a baby and need to change their coverage can now do that online instead of having to make a phone call.

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The exchange is also working to add lists of in-network physicians and specialists to its site so that patients don’t have to go to their insurance companies to find out whether they can see a doctor.


One quirk of the District’s exchange is that members of Congress and their staffs are required to buy insurance through the city’s small business exchange if they want the federal government to contribute to the cost of their coverage. The upshot is that the majority of the more than 14,000 people who’ve signed up through the small business exchange don’t work for mom-and-pop operations — they work on Capitol Hill.

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