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Life Health > Health Insurance

D.C. exchange to set HSA-compatible plan mandate

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Members of the District of Columbia Health Benefit Exchange Authority board are assuming that the district’s exchange will be selling health coverage for 2018 starting Nov. 1, and that some of the customers will want to use health savings accounts.

Board members voted Wednesday to require any insurers that sell coverage through the DC Health Link exchange to offer bronze-level plans that are compatible with the HSA program, according to an audio recording of the meeting posted on the exchange website.

The District of Columbia has a locally run Affordable Care Act public exchange with about 24,000 users.

Related: Court blocks ACLI challenge to D.C. exchange insurer fee

The Affordable Care Act requires members of Congress and some of the lawmakers’ aides to get their health coverage from the ACA exchange system. Most of the congressional ACA exchange users get their health coverage through the DC Health Link small-group coverage exchange division. That has made DC Health Link the only ACA exchange other than Vermont that gets the majority of its business from the small-group division.

Related: Congress to use D.C. small-group exchange

The two insurers that are selling individual coverage through DC Health Link this year, a unit of Owings Mills, Maryland-based CareFirst Inc. and a unit of Oakland, California-based Kaiser Permanente, have agreed to try offering gold-level HSA-compatible plans voluntarily, exchange officials said.

HSA-compatible health insurance must comply with deductible and annual out-of-pocket spending maximum limits set by the Internal Revenue Service. For 2017, for example, an HSA-compatible individual policy must have a deductible of at least $1,300 and annual out-of-pocket spending of $6,550 or less.

The U.S. Department of Health and Human Services operates (Photo: iStock)The U.S. Department of Health and Human Services operates (Photo: iStock) is an ACA exchange enrollment and account administration system for states that are unwilling or unable to run their own exchange enrollment systems. HHS also regulates the locally run ACA exchanges.

At, HHS has been encouraging issuers to offer standardized plans that are easy for consumers to compare on an apples-to-apples basis.

The D.C. exchange board encouraged D.C. issuers to offer standardized plans for 2017. One side effect of the standardization effort in the District of Columbia is that one carrier, the CareFirst unit, eliminated its HSA-compatible exchange plans.

The exchange “received consumer and broker complaints about this development,” according to a plan strategy advisory group report.

Federal regulators have created four major categories of coverage, with bronze plans covering about 60 percent of the actuarial value of a standardized benefits package; silver plans, 70 percent; gold plans, 80 percent; and platinum plans, 90 percent.

In most states, exchange plan users have gravitated toward bronze and silver plans.

In the District of Columbia, advisory board members had trouble deciding whether many DC Health Link users would want HSA-compatible gold plans. CareFirst and Kaiser agreed to overcome disagreement on the advisory board about the issue by offering HSA-compatible gold plans in the district in 2018.

President Donald Trump and many Republicans in Congress have talked about repealing “Obamacare.” Trump has not yet defined what parts of the Affordable Care Act or other laws and programs he includes in the term “Obamacare.” Some Republicans in Congress have proposed bills that would repeal all of the Patient Protection and Affordable Care Act of 2010, and all of the health-related parts of the Health Care and Education Reconciliation Act of 2010, the other law in the two-part ACA package.

Trump has not talked about what he wants to do with the public exchange system. Some Republican lawmakers’ proposals for changing the ACA have called for letting states decide whether to keep their public exchange programs. 


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