District of Columbia: Individual Mandate Officially Reinstated...but is it too late to lower 2019 rates?
Way back in February, the board of directors of the DC ACA exchange board unanimously recommended that the District reinstate the individual mandate penalty, as well as putting strict restrictions back onto short-term plans. This recommendation was later agreed to by the DC Council in their proposed 2019 budget. In July, Congressional Republicans made an effort to quash DC bringing the mandate penalty back, but fortunately, it sounds like their effort failed:
Quick coda (corrected): DC Mayor Bowser the signed individual mandate yesterday, as part of the FY2019 Budget Support Act. (This was expected -- she proposed it.) Congrats to DC for showing how states can lead the way on health care. Act as signed is at https://t.co/aW3fSBSu2n
— Jason A. Levitis (@jasonlevitis) September 6, 2018
The 2019 budget act restores the mandate exactly along the lines of the one which was repealed by Congressional Republicans last December...around $700 per enrollee or 2.5% of their household income for those not acquiring ACA-compliant healthcare coverage.
Meanwhile, back in June, DC carriers submitted their preliminary 2019 premium increases, averaging around 15.5%...and at least one carrier made it pretty clear that repeal of the mandate was the cause of a pretty significant portion of their rate hike:
Here's my estimate of the DC situation at the time without the mandate penalty being reinstated: A 15.5% average rate increase, with an estimated 9.1 percentage point impact due to the combination of mandate repeal + #ShortAssPlans:
In mid-August (before the mandate reinstatement was official), the DC exchange held a public hearing to discuss the rate requests. Here's a couple of relevant slides from the presentation in which it appears that they were planning on reducing GHSMI's rate change significantly (from 16.7% to 10.2%), raising CareFirst's slightly (from 9.5% to 9.5%) and approving Kaiser's as is at 20%:
I'm not sure what the final decision was (or will be), but here's what it would look like if those end up being the final numbers:
The mandate has apparently been officially reinstated, and I think the short-term plan restrictions were also put back into place, so this should mean the carriers will issue last-minute revisions of their 2019 rate filings. However, with the deadline for signing the actual, final contracts for 2019 coverage coming up in just a few weeks, there may not be time to do so.
I'll look into this and post an update if/when I find out anything more.