When Congress passed the Patient Protection and Affordable Care Act in 2010, it required states and the District of Columbia to set up health care exchanges by 2014 to help the uninsured, self-insured, low-income earners and small-business owners purchase health insurance coverage at competitive rates previously available only to large business enterprises.
D.C. became the first jurisdiction in the nation to comply when it established the D.C. Health Benefit Exchange Authority. The District has already received more than $82 million in federal grants to set up its exchange. The city's own website notes: "Nobody will be required to purchase health insurance through the Exchange ... If you would prefer to buy your insurance through an insurance agent or broker, you will be free to do so."
But an ill-advised proposal has been floated that would take away this freedom from individuals who own or work in businesses with fewer than 100 employees or who buy their own policies outside of work. The measure, which the Exchange Board was to consider Wednesday night, would limit consumers' and businesses' choices, making the Exchange "the sole marketplace in the District of Columbia for the purchase of individual and small group health insurance plans."
Employers rightly fear that they will end up with different insurers and higher rates, as The Examiner's Liz Farmer reported Wednesday. This is why the District Council would be wise to reject any such proposal out of hand as needless meddling in residents' lives, more likely to do harm than good.
The Exchange Board, chaired by former health director Mohammad Akhter, wants to establish the Exchange as the monopoly marketplace, potentially affecting 80,000 people who already have health insurance. Akhter claims that without a monopoly, there won't be enough participants in the Exchange to spread the risk. Wayne Turnage, director of the D.C. Health Care Finance Department and a nonvoting board member, told the Washington Business Journal in July that "without giving the exchange the luxury of being the only insurance marketplace in the District, it's almost impossible to build something that's sustainable."
But as DC Chamber of Commerce CEO Barbara Lang point outs, an Exchange monopoly would more likely reduce competition and raise insurance costs for individuals and small businesses. A report for the city by consulting firm Mercer predicted that most small employers in the District would wind up dropping their coverage altogether -- a result predicted by Obamacare opponents before the law was passed.
Only 7 percent of D.C.'s population is uninsured -- a rate much lower than the national average. Only a bureaucrat could believe that the best way to cover that last 7 percent is to upend the insurance arrangements of nearly twice as many already insured D.C. residents.
D.C. resident Peter D. Rosenstein, an Obama supporter, complained in the May 3 Huffington Post that it would be "harmful" if "plans for less than 10 people, like the ones many small businesses and not-for-profit associations in the District currently insure their employees, would no longer be available even if the businesses and employees are totally satisfied." At the very least, it certainly contradicts President Obama's promise that "if you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what."