by Judith Ryan
An illustrious panel discussed health care in the District of Columbia, at the LWVDC annual fall luncheon, held October 14 at Carmine’s Italian Restaurant. Speakers were Mila Kofman, Executive Director, DC Health Benefit Exchange Authority; Congresswoman Eleanor Holmes Norton; and former Mayor Vincent Gray, currently Ward 7 Councilmember and Chair of the Council`s Health Committee.
Ms. Kofman, previously of the Georgetown Health Policy Institute, reported the DC Health Benefit Exchange was created in January 2013, as a quasi-government authority that is locally managed and oversees thousands of plans for individuals, small businesses and employees on Capitol Hill -- including those from Kaiser Permanente and Care First. All of them come under the title of DC Health Link.
Ms. Kofman said Obamacare is not the disaster it has been portrayed to be but rather has provided great savings, thanks to reduced premiums. The Affordable Care Act (ACA) has cut the number of uninsured in DC in half and 96 percent of the DC population now has health coverage. In addition, Kofman said, DC Health Link has been ranked #1 for Consumer Tools Offered, i.e. the IT tools that are made available.
Kofman also examined “What the Trump Administration (proposal) means for us (DC),” highlighting that employers would not be required to provide coverage for birth control and Cost Sharing would no longer be important to reimburse insurance companies, a matter of some $7 billion. Moreover, by Executive Order, unregulated insurance companies could sell unregulated policies. As a result, she predicted, there would not be a private market left.
View from the Hill. Congresswoman Norton, giving an overview of the health care realities in DC, said most residents have employer-based health care. DC Health Links is for employed residents whose insurance is not paid for by their employers.
According to Norton, most insurance companies are in favor of ACA, and they have much to gain because the law provides the largest pool of customers, something which is essential.
Norton said never in US history has an entitlement been taken away, adding that “if we don’t stabilize this market, it will affect 20 per cent of our economy.” Among other ill effects, she said, the Trump Administration has taken away 90 per cent of the money supposed to publicize enrollment and closed the website on weekends, harming enrollments. Further, allowing association health care plans and companies to cross state lines will cause 7 million people to lose their coverage.
Norton pondered: “Why is Trump doing this?” Her answer: to force negotiations. “Two senators, Lamar Alexander and Patty Murray are working on a compromise.” Nobody wants the health insurance market to collapse 20 per cent of our economy, she said, adding that the earliest these Trump proposals would go into effect is 2019.
Vincent Gray praised DC Health Links as the best of the exchanges and said Repeal and Replace would have been devastating to DC. The Affordable Care Act was a great windfall because all the residents who had been covered under the DC Health Care Alliance (created under Mayor Anthony Williams) were moved to ACA. With Repeal and Replace, he said, DC would have lost $4-5 billion.
According to Gray, the biggest item in the DC budget is not police, fire, or education, but the Department of Health Care Financing, which has a budget of $4 billion and oversees Medicaid. Moreover, he emphasized, Medicaid is a very large and important component of health care in DC. Looking further at health care issues specific to DC, Gray underscored:
There is no “health care” on the “East Side” (Wards 7 and 8) of the city.
$336 billion put in the budget while he was Mayor and then taken out is now back in the budget at $300 billion to build a hospital on the grounds of St. Elizabeth’s. But a health care system is more than a hospital.
Health-related issues he is exploring include the “food desert” in Wards 7 and 8 where only three grocery stores serve 150,000 residents; universal pre-kindergarten for all 3- and 4-year olds as well as preschool from birth to age 3 in Wards 7 and 8, and nurses in all schools.