District of Columbia

SCI Policy Planning Grant

In 2005 the District of Coumbia was awarded an SCI Policy Planning Grant.  The grant supported actuarial analysis of a risk transfer concept in the District Insurance Commissioner's "Equal Access to Health Insurance Act," a proposal that created a purchasing pool that builds on the already existing size and stability of the District's public employees.

The Equal Access Act proposed to establish the District of Columbia Health Benefit Program and Health Insurance Risk Transfer Pool, through which all persons who live, work, or are enrolled in a program of higher education in the District have access to a health insurance program that provides the choices and protections currently available only to those who work full-time for large employers.

The D.C. Health Benefit Program functioned like a purchasing pool for employers and individuals with unique features. The program usef as a base the District government's employees to provide the stability of a large pool of insured individuals. The program then developed a risk transfer pool to address the potential adverse risk selection issues that could occur with a voluntary pool; it augmented the District-wide purchasing pool. The risk transfer pool allowed all commercial carriers participating in self-funded employer plans and stop-loss and reinsurance carriers to transfer claims for high-cost enrollees into the pool.

The SCI grant provided funding to the D.C. Department of Insurance, Securities and Banking to conduct actuarial analysis to assess the effects of this program on the insurance market, existing public programs, and level of uninsurance in the District.