Taxpayer Suit Against DC HBX’s Acceptance of Congressional Members & Staff

The attached federal lawsuit was filed earlier this month against the DC HBX. The attached link provides the Judicial Watch press release on the suit. The plaintiff, Mr. Vining, is a DC resident and local taxpayer.

The policy implications of this suit, assuming it is successful, are two-fold:

1.) There are roughly 12,000 congressional members and staffers who have joined the DC SHOP exchange – representing the vast majority of total SHOP enrollees, now totaling about 14,400 members.

2.) Given the demographic characteristics typical of congressional staffers, their experience adds meaningfully younger (and therefore healthier) risks to the DC HBX, thereby facilitating a healthier overall SHOP risk pool.

Please let me know if you have questions.

Kevin Wrege, Esq.

Founder & President

Pulse Issues & Advocacy LLC

Office: 202-625-1787

Mobile: 202-253-4929

4410 Massachusetts Ave., NW, #150

Washington, DC 20016

Vining-v-DC-Health-Benefit-Exchange-Complaint re Congress on DC Exchange.pdf


Mayor Vincent Gray kicks off moveDC plan

Mayor Vincent Gray kicks off moveDC plan

By Luz Lazo, Washington Post, October 21 at 2:16 PM

D.C. Mayor Vincent C. Gray on Tuesday released an ambitious long-range transportation plan that he said would expand the city’s transit options while deterring driving through the use of toll lanes on the city’s gateways and charging a congestion fee to motorists entering downtown.

MoveDC, looks ahead to 2040 and envisions a wide transit network that includes a streetcar system, dedicated bus lanes in major commuter corridors, expanded Metrorail service in the downtown core, an active water taxi system and 200 miles of on-street bicycle facilities.

To ensure the plan is implemented, Gray launched an action plan Tuesday that lays out 36 key steps the city will take over the next two years to advance the vision. The two-year action plan includes some capital investments in infrastructure, the advance of several transportation studies and some policy changes.

“MoveDC is about being able to expand choices for all modes or methods of getting around the city,” said Gray, whose term ends in January. He said he has every confidence that the 25-year plan will be carried out. “I don’t know what changes future mayors will make, but the fundamental direction in this plan will be made.”

Some of the key steps over the next two years are:

  • Begin construction of a new Frederick Douglass Memorial Bridge over the Anacostia River. Transportation officials project construction will begin next year. A new bridge would provide wide sidewalks and bike facilities and serve as an important gateway for people east of the river into downtown.
  • Complete DDOT’s traffic signal optimization project to enhance the District’s traffic signal network. The city plans to finish optimizing each of the 1,600 signals by 2016.
  • Add sidewalks where they are missing, with priority to areas near schools, parks, and transit.
  • Improve pedestrian safety at 20 or more intersections.
  • Complete the Klingle and Kenilworth Anacostia Riverwalk Trail projects and advance the Rock Creek and Metropolitan Branch Trail projects
  • Continue the expansion of the bike network by installing or upgrading 15 miles of on-street bicycle facilities
  • Complete bus priority improvements: DDOT plans to install dedicated bus lanes on Georgia Avenue from Florida Avenue to Barry Place, transit signal priority on 16th Street, and real-time arrival information in shelters citywide. DDOT officials say they plan to work with Metro to implement signal improvements in at least 10 locations on high-ridership corridors to expedite the bus service.
  • Reduce by half the number of structurally deficient bridges. DDOT officials say in the pipeline are investments for improvements at several of the city’s most used bridges including the 16th Street Bridge and the Key Bridge.

DDOT Director Matthew Brown said the short-term action plan will keep DDOT and other agencies on track to advance the vision. Officials say a discussion and a plan about how to pay for the $54 billion moveDC plan have yet to be addressed. Gray said among the most immediate concerns are restoring funding for the proposed 22-mile streetcar network. The D.C. Council voted to sharply roll back Gray’s proposed budget for the streetcar system, something that he says imperils the system before it even begins service.

“This funding needs to be restored,” Gray said. “It is going to cost the city more money to not have the streetcar program fully in the city.”

As part of the short-term goals, DDOT will proceed with several studies, including how to increase bus capacity in the 16th Street NW corridor where some transit users and advocates have been calling for the implementation of dedicated bus lanes. The agency also plans to advance a study on bicycle infrastructure on the east side of downtown, the federal environmental review process for the streetcar system and a comprehensive rail plan for the city.

Cheryl Cort, policy director at the Coalition for Smarter Growth, said the plan provides a big vision for how the city will move in the future and welcomed the two-year action plan as a good strategy to advance the vision.

“We can check and keep track and see how we are going to move forward,” she said.

Luz Lazo writes about transportation and development. She has recently written about the challenges of bus commuting, Metro’s dark stations, and the impact of sequestration on air travel.

D.C. Health Link gets sued again. This time, it’s because of Congress.

D.C. Health Link gets sued again. This time, it’s because of Congress.

Oct 20, 2014, 2:56pm EDT

Conservative group called Judicial Watch is behind the latest challenge to D.C.’s Health Benefit Exchange Authority in District Superior Court.

Tina Reed

Staff Reporter- Washington Business Journal

A conservative group called Judicial Watch is behind the latest challenge in District Superior Court to D.C.’s Health Benefit Exchange Authority. A lawsuit filed by District resident Kirby Vining accuses D.C. Health Link of accepting documents from the House and Senate that say they employ less than 50 people in order to use the small business exchange for their employees, the Washington Times reported.

When drafting the law in 2009 and 2010, members of Congress required themselves and their staffs to use the exchange to buy coverage. It was good news to D.C. exchange developers and insurance plans competing for business because it steered thousands of generally healthy, relatively young people into the exchange. It also meant small, private businesses in the District joining the exchange would have a broader base over which to spread actuarial risk.

This is the second lawsuit challenging the strategies the District has used to make its own exchange a viable option, since it has such a small population compared with most states.

Earlier this year, the American Council of Life Insurers sued the exchange because of its funding source, a 1 percent tax on all "health-related" insurers meant to make the exchange sustainable. The suit filed on behalf of all insurers that can’t sell their products on the exchange say they do not directly benefit from the exchange and shouldn’t be forced to pay for it. The District has said all insurers benefit from a healthier population and therefore are direct beneficiaries who should support the exchange.

The tax was collected Sept. 30 in advance of the fiscal year, when the District was required to show it could sustain its own exchange.

A District judge has yet to rule on that case.

District Health Benefit Exchange Authority Director Mila Kofman is named in the suit. The exchange and the District’s Office of the Attorney General declined to comment.

Kofman told Kaiser Health News earlier this year companies opposing the tax have threatened legal action and are worried other states might follow D.C.’s lead with the funding strategy. The tax on insurers was necessary, officials have said, because the city does not have the volume other states have to make the exchange self-sustaining. The District would have had to charge a 17 percent tax on every health plan sold on its website to cover its budget.

"Being a small state, we have to think differently about how we finance D.C. Health Link and the implementation of the Affordable Care Act," Kofman told the D.C. Council Committee on Health earlier this year.

Tina Reed covers health care.

New D.C. mayor poll: Bowser over Catania by 12 points

New D.C. mayor poll: Bowser over Catania by 12 points

By Mike DeBonis, Washington Post, October 20 at 3:21 PM

A new poll finds Democrat Muriel E. Bowser with a double-digit lead over independent David A. Catania with 15 days left in the D.C. mayoral race.

Bowser carried 45 percent support among likely D.C. voters, with Catania holding 33 percent support and fellow independent Carol Schwartz with 12 percent. Only 7 percent said they were undecided.

The survey was commissioned by Economic Growth D.C., a pro-business advocacy group, and reached 800 likely voters via landlines and cellphones between Thursday and Sunday. It was performed by Greenberg Quinlan Rosner Research, a prominent Democratic polling firm, and carries a margin of error of plus or minus 3.5 points.

Economic Growth D.C. commissioned the last published poll of the mayor’s race, which found an 8-point margin between Bowser and Catania in late September.

Like the previous poll, the new Economic Growth D.C. poll selects respondents from a voter list rather than by dialing random numbers, as in most media polls. In the late September survey, 53 percent of likely voters were white, while 42 percent were African American. In the new poll, 48 percent of likely voters are black and 43 percent white — hewing more closely to the demographic split seen in the mid-September NBC4/Washington Post/Marist poll that put Bowser 17 points ahead of Catania.

The earlier poll showed 27 percent undecided, while the new poll shows 7 percent undecided. “It seems that Democrats who may have been on the fence have come home to council member Bowser,” said Dave Oberting, Economic Growth D.C.’s executive director. “Any momentum that Catania might have had seems to have been blunted.”

Still, a memo prepared by the polling firm identified “an element of fluidity left in the race” despite Bowser’s lead: “One-in-five voters in this electorate are weak Bowser supporters, and another 7 percent remain undecided. Further, as the following table shows, Bowser’s advantages on key images all fall short of her overall 12-point lead on the ballot.”

On two of those “images” — “Will improve the economy and create jobs in the District”; “Represents people like me” — Bowser holds a significant advantage over Catania. On the other hand, voters asked who “will work with the business community to grow and create jobs” and who “represents a change from the current administration” give Catania an advantage. On the questions of who “will reduce crime and drugs” and who “will improve public schools,” Bowser and Catania are statistically tied.

Peyton M. Craighill contributed to this post.

The Post endorses Muriel Bowser for D.C. mayor

The Post endorses Muriel Bowser for D.C. mayor

WASHINGTON, DC – SEPTEMBER 18: Muriel Bowser (D) makes her introduction speech at the first DC Mayoral debate in Washington, DC on September 18, 2014. (Linda Davidson/The Washington Post)

By Editorial Board October 17 at 1:40 PM

D.C. RESIDENTS have reason to be disaffected with city government and politics. The incumbent mayor has operated under the shadow of the illegal campaign fundraising that helped to put him in office. Three members of the D.C. Council left their offices in disgrace. This sad state of affairs played a part in the unusually low turnout for the April primary, and it may help explain why many voters say they remain uninspired by the mayoral election just 2½ weeks away.

We hope they look again. This is a critical election, and it offers a clear choice. Despite the ethical cloud that has hung over Mayor Vincent C. Gray and contributed to his defeat in the Democratic primary, he will leave office in January with the city on generally sound footing. Its finances are healthy, its schools are attracting more families every year and many neighborhoods are reinvigorated. His successor must maintain that momentum while providing the leadership to confront new challenges.

Muriel Bowser, Ward 4’s representative on the council and the Democratic nominee, is the candidate best prepared to provide that leadership. We endorsed her in the primary but acknowledged it was not an easy choice because of the capable opponents then running against her. We faced no such dilemma this time. Neither council member David A. Catania (I-At Large) nor former council member Carol Schwartz comes close to Ms. Bowser in temperament, work ethic, ideas, policy understanding and balanced approach.

We don’t discount Ms. Schwartz’s past accomplishments (notwithstanding her wrong-headed opposition to the mayor’s takeover of the schools) or her love of the city, but sentimentality cannot advance the District or the interests of its residents. She has failed to present a credible rationale for her independent candidacy.

Mr. Catania also can point to accomplishments in his 17 years on the D.C. Council, including his advocacy for same-sex marriage and his oversight of health care in the District. But he also has been on the wrong side of many important issues. If it were up to Mr. Catania, it is likely there would be no city-financed baseball stadium for the Nationals to play in and no convention center to attract visitor dollars, not to mention the hundreds of jobs created by both projects. The money-draining D.C. General Hospital might still be limping along. That Mr. Catania seems unable to concede he might have been wrong is all the more troubling.

Also worrisome has been Mr. Catania’s stewardship of the council’s education committee, which roughly coincided with his interest in becoming mayor. Instead of forging a meaningful collaboration with the city’s able schools chancellor, Kaya Henderson, he set out to pass a series of bills that were sure to capture headlines but would do little to improve schools. D.C. schools are on the mend because Mr. Gray and his predecessor, Adrian M. Fenty (D), put competent professionals in place and let them do the job. The well-documented concerns about Mr. Catania’s temperament raise questions about what kind of leader he would be — “bully” is a word that crops up with disturbing frequency — and have been amplified by the often mean-spirited campaign he has run.

Ms. Bowser, by contrast, has grown only stronger as her candidacy has progressed. A lifelong Washingtonian, she is well positioned to bring substance to the “One City” motto that Mr. Gray articulated but had trouble fulfilling. She is committed to better serving longtime residents, especially the poor who have benefited least from Washington’s rise, but also appreciates the urgency of attracting businesses and welcoming new residents. Her travel to other cities has given her insights into what works and what doesn’t and bespeaks a refreshing willingness to admit there are things she doesn’t know.

Those critical or jealous of Ms. Bowser have painted a caricature of a lightweight. That is not the tough politician we have come to know and admire in her seven years on the council. She strikes us as smart, capable and confident without being arrogant. On the council, she has learned the ins and outs of government, from zoning to ethics to tree canopies. As mayor she says she would set priorities, find the right people to pursue them — including a professional city administrator — and give them the support to get it right. She has said that chancellor Henderson and Police Chief Cathy L. Lanier would be among those on her team, if they agree to stay.

We enthusiastically endorse Muriel Bowser. She is the clear, best choice for voters on Nov. 4.

Bowser Wins Ward 8 Straw Poll as Candidates Face Each Other and Rowdy Crowd

Bowser Wins Ward 8 Straw Poll as Candidates Face Each Other and Rowdy Crowd

Posted by Will Sommer on Oct. 16, 2014 at 10:52 pm

Apparently, they can get along. The District’s three top mayoral candidates, whose previous encounters have featured enough pugnacity to earn a resolution from At-Large Councilmember Vincent Orange, decided to take it easy on each other tonight at Anacostia High School for the final major debate of the season. The result: actual discussions of policy.

"What gives?" thought LL. Apparently the crowd agreed, as Muriel Bowser and David Catania supporters teamed up to nearly derail the debate with their heckling.

The forum, sponsored by various Ward 8 civic groups, kicked off with a straw poll. Bowser eventually won the vote limited to residents of the simpaticoward with 169 votes, 70 percent of the total ballots cast. David Catania received 69 votes, while Carol Schwartz won 16.

The usual festive straw-poll atmosphere was in evidence, too. Young girls performed choreographed cheers for Muriel Bowser. Anti-David Catania activists in signs and T-shirts without the mandatory Office of Campaign Finance credit lines accused the candidate of waging a war on the poor, while Ward 8 councilmember Marion Barry made an appearance to cast a ballot for Bowser. (At one point during the debate, all three candidates said they would take Barry’s phone calls personally if elected.)

WUSA9 reporter Bruce Johnson‘s questions focused on Ward 8. Asked to name their greatest contribution to Ward 8, Bowser mentioned free Metrobus rides for students, while Catania chose the United Medical Center hospital bailout. Schwartz named her paid sick leave bill, but not before a man in the audience shouted that Schwartz couldn’t come up with anything she had done for the ward.

It was a sign of things to come. In the most extended heckle of the debate, Bowser begged a woman in the audience by name to settle down, while a who’s who of east-of-the-river activists, plus a security guard, intervened. Johnson looked ready to call it quits, but the debate managed to limp on anyway. (LL’s other top heckles: a Bowser heckler telling a Catania heckler to "shut your mouth, shut your face," and Barry Farm activists effectively mic-checking the debate).

Asked about Vince Gray‘s school boundaries proposal, Bowser worried that the changes would lock east-of-the-river students out of quality schools across the Anacostia River. Schwartz struck a similar, if more strident, tone, vowing that Brown v. Board of Educationwould not be undone under her watch. Catania put his chairmanship of the D.C. Council education committee to good use, launching into a wonky discussion of how the changes would mortally wound one middle school.

Instead of attacking one another, the candidates set their sights on one person: City Administrator Allen Lew, architect of the school overhauls and the D.C. United stadium deal. Considering what position the candidates would turn over in their own administration, both Catania and Schwartz said they’d put someone new in Lew’s position. Bowser didn’t quite tell Lew to update his LinkedIn connections, naming the fire chief as her priority.

The debate’s location made for an interesting consideration of two other mayors—Gray and Adrian Fenty. Gray, although toxic in much of the rest of the city, remains popular in Ward 8 even as his predecessor isn’t. But Bowser, apparently Ward 8’s favored candidate after defeating Gray in the primary, rose to prominence as Fenty’s protege.

Faced with these obstacles, the candidates eagerly twisted themselves into pretzels. Asked whether Gray got a raw deal from Jeff Thompson‘s pre-primary plea deal, Catania (who called for Gray’s resignation two years earlier), declared that U.S. Attorney Ron Machen appeared to tilt the primary against Gray with the plea. Bowser, who understandably appears to see critiques of "Machen Monday" as an attack on the legitimacy of her primary win, was more reticent.

Bowser faced her own Ghost of Mayors Past when Johnson asked her how she was different from Fenty. Bowser described Fenty as a friend who taught her to be "impatient with incompetence." At the same time, though, Bowser said that Fenty’s "dramatic fall" showed her to "never lose touch with the people." A pretty nice way to call the guy a jerk, LL thinks.

Aside from some jabs over Schwartz and Catania’s former GOP affiliations and Catania’s old job with city contractor M.C. Dean, the candidates treated each other surprisingly well.

They even turned down the always brutal opportunity to ask one another questions. Three weeks from now, LL wonders who will be wishing they had taken it.

File photo by Darrow Montgomery

Need help getting your insurer’s approval? There’s apparently a D.C. ombudsman for that

Need help getting your insurer’s approval? There’s apparently a D.C. ombudsman for that

Oct 13, 2014, 3:00pm EDT Updated: Oct 14, 2014, 7:59am EDT

D.C. Health Care ombudsman

D.C. has a health care ombudsman? Don’t feel bad if you didn’t know. The office is launching its first campaign to advertise its services this week.

Tina Reed

Staff Reporter- Washington Business Journal

Did you know D.C. has a “ health care ombudsman"?

If you didn’t, you’re not alone. For five years, the small office within the Department of Health Care Finance charged with helping residents and workers when insurers deny their claims has been operating under the radar.

With the onset of open enrollment for health plans, the Department of Health Care Finance started trying to change that for the first time. This week, the office began advertising its new ”Healthcare On Tap” campaign to any D.C. residents or workers having trouble with Medicaid, Medicare, their employer-based insurance and even the coverage they purchased on the District’s exchange, D.C. Health Link.

The profile-raising campaign includes a TV commercial showing residents contacting the small office with questions about problems with their insurance via decidedly low-tech tin cans attached to strings. It was funded in part through federal grants, including one for about $200,000 made available under the Affordable Care Act.

“People don’t appeal the decisions, the denials that insurance companies give them. They just accept them. They don’t know they can appeal,” said Health Care Ombudsman Maude Holt.

The office has about a dozen full-time people and four interns to help address calls for help from people who live or work in the District, Holt said. They pore over plans to see if individuals actually should receive coverage under their plans and try to persuade insurers to overturn their decisions — or work with the affected residents to change their policy should they learn they aren’t eligible for coverage, Holt said. The Department of Health Care Finance handled some 6,500 cases in fiscal year 2013. They say they were able to resolve 95 percent of those cases successfully, although the definition of success seems to vary widely.

Among one of their side roles, Holt said, is actually talking to businesses directly about the benefits they offer when they notice glaring gaps. An example, she said, many plans don’t cover the cost of wigs as prosthesis to women being treated for breast cancer. The office doesn’t have the authority to make the business change their coverage but can make recommendations regarding benefits that may ultimately help them.

“A healthy population is a more productive population,” Holt said.

Tina Reed covers health care.