Muriel Bowser, D.C. mayor: Obamacare repeal to cost the city more than $600M

D.C. Mayor Muriel Bowser warned Congress Friday that repealing the Affordable Care Act would cost the city more than $600 million dollars per year.

In a letter sent to House Majority Leader Kevin McCarthy, the mayor touted the District’s success with the ACA, citing that 96 percent of the city’s residents were extended coverage through the law.

“ACA has also created more competition and driven down costs, and now many District residents and small businesses have affordable health coverage for the first time,” Miss Bowser said. “The repeal of all or part of the Affordable Care Act would disrupt our insurance market, impair insurers, and increase costs to the District and consumers.”

Miss Bowser said the letter was in response to a request from Mr. McCarthy asking states to share their ideas for reforming the nation’s health care system. She estimates repealing the law will cost the city $623 million.

Congressional Republicans have long wanted to gut President Obama’s signature health care achievement. And on Wednesday, Vice President-elect Mike Pence met with GOP leaders in the House and Senate, kicking off the latest effort to repeal the legislation.

Mr. Pence said President-elect Donald Trump would dissemble the ACA through a combination of executive orders and legislation.

The mayor’s letter also outlines in detail how the District has been affected by the launch of D.C. Health Link — the city’s online insurance marketplace.

• One in four residents who signed up for insurance through the government website during the last open-enrollment period were previously uninsured.

• One in two people eligible for Medicaid under the ACA were previously uninsured.

• Four in 10 small businesses did not offer health insurance to their employees prior to enrolling through the city’s insurance website.

The District’s insurance rates through D.C. Health Link rose by 7 percent on average this year for individual plans compared to 2016. Small group plans saw a 0.36 percent increase for small group plans.

In May, insurers sent their rate hike requests for 2017 to the D.C. Department of Insurance, Securities and Banking (DISB), who negotiated and approved revised rate increases in late September. DISB at the time touted that three out of the four insurers reduced their rates from their initial filings.

Much of the individual 7 percent increase came from CareFirst HMO, which upped rates by nearly 23 percent and Kaiser Permanente HMO, whose rates jumped by 12 percent, according to DISB statistics.

The 7 percent bump is relatively small compared to the increases of up to 30 percent in neighboring Maryland, where the lowest insurance plan rate hike came in at just over 20 percent.

Miss Bowser said about 19,000 residents have insured themselves through D.C. Health Link, and 60,000 people have done so through the city’s small business insurance marketplace. She also said the ACA’s expanded Medicaid coverage insured about 75,000 childless adults.

“Without federal support, such expansion would not have been possible,” Miss Bowser said. “While the cost for expanded coverage for childless adults is more than $468 million, the local share of this cost is approximately $58 million.”

That number is expected to rise to 90,000 childless adults needing insurance through Medicaid, costing more than $623 million. About $60 million of which will be local costs.

“Many of these persons have complex medical problems, would be considered high risk in the private market, and could not afford unsubsidized premiums,” Miss Bowser said.

But if Congress is resigned to repeal the ACA, Miss Bowser said she’d be looking closely to make sure the alternative doesn’t put the city at greater financial risk and that District residents maintain their coverage under any new scheme.

“Expanding upon, not limiting or reducing, affordable health care coverage is a priority,” Miss Bowser said.