An 1818 map of the District of Columbia (Image courtesy of the Bryn Mawr College cities department)

The District of Columbia may use the same exchange, or Web-based health insurance supermarket, for both the individual market and the small group market.

Members of the board of the District of Columbia Health Benefit Exchange Authority voted unanimously Wednesday to approve a market consolidation proposal, according to Scott Golden, a representative for a coalition that opposes the consolidation proposal.

The proposal appears to require D.C. small businesses to buy coverage through the exchange, rather than encouraging them to do so, according to the Washington Examiner.

The exchange board has said that it believes it can implement the proposal without getting the approval of the Washington, D.C., city council. Members of the anti-consolidation coalition are objecting to that interpretation.

Members of the anti-consolidation coalition believe that putting the D.C. individual and small group markets on one exchange will shut down the private market for individual and small group coverage in the district, Golden said.

“In its place, health care consumers would be forced to buy coverage from a limited selection of health plans on the government-run exchange,” Golden said.

The coalition Golden represents includes the National Association of Health Underwriters and groups such as the American Immigration Lawyers Association and the D.C. Chamber of Commerce.

The list of groups backing the letter does not include the National Association of Insurance and Financial Advisors, but the copy of the letter sent to LifeHealthPro is posted on NAIFA’s website.

“As we understand it, very few – if any – states have attempted to immediately merge the Individual and Small Group markets or to eliminate the commercial marketplace,” the groups wrote in a letter to Dr. Mohammad Akhter, chairman of the D.C. exchange executive board, in September. “While we commend the District for seeking to be a national leader in implementing federal health care reform, it’s far more important that you get it right than that you get it  first.”

The Patient Protection and Affordable Care Act of 2010 (PPACA) requires states and the District of Columbia to set up government-run exchanges by 2014. Federal regulators have asked states and the district to decide whether to combine their individual and small group exchanges or to keep them separate and to make  other choices about how their exchanges will operate.

Correction: An earlier version of this article described NAHU’s location incorrectly. NAHU has moved to Washington.

See also: