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Councilmember Anita Bonds
Councilmember Christina Henderson 3
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Councilmember Janeese Lewis George Councilmember Robert C. White, Jr. 7
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Councilmember M atthew Frumin 11
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A BILL 13
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IN THE COUNCIL OF THE DISTRICT OF COLUMBIA 18
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To amend the Reasonable Health Insurance Health Insurance Ratemaking and Health Care 23
Reform Act of 2010 to allow private insurers and Medicaid managed care organizations 24
to include expenditures for certain social determinants of health services in their medical 25
loss ratio. 26
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BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this 28
act may be cited as the “Social Determinants of Health Spending Amendment Act of 2025”. 29
Sec. 2. Section 103 of the Reasonable Health Insurance Ratemaking and Health Care 30
Reform Act of 2010, effective April 8, 2011 (D.C. Law 18 -360; DC Official Code § 31–31
3311.02) , is amended as follows: 32
(a) A new subsection (a-1) is added to read as follows: 33
“(a-1) An insurer may include specific evidence -based expenditures related to initiatives 34
that address social determinants of health in the numerator of their medical loss ratio calculation 35 when the initiative is designed to improve the health of District residents and to reduce health 36
disparities. Eligible expenditures shall include: 37
“(1) Initiatives addressing food in security and nutrition education; 38
“(2) Services promoting access to community-based programs for justice-involved 39
individuals upon reentry; and 40
“(3) Supporting continuity of care for populations experiencing housing instability.”. 41
(b) A new subsection (g) is added to read as follows: 42
“(g) For purposes of this section, the term “social determinants of health” (SDOH) means 43
the conditions in the environments where people are born, live, learn, work, play, worship, and 44
age that affect a wide range of health, functioning, and quality- of-life outcomes and risks; SDOH 45
refers to community-level factors, as defined by the Centers for Medicare and Medicaid 46
Services, as adapted from the Centers for Disease Control and Prevention Healthy People 2030 47
definition.”. 48
Sec. 3. Fiscal impact statement. 49
The Council adopts the fiscal impact statement in the committee report as the fiscal 50
impact statement required by section 4a of the General Legislative Procedures Act of 1975, 51
approved October 16, 2006 (120 Stat. 2038; D.C. Official Code § 1- 301.47a). 52
Sec. 4. Effective date. 53
This act shall take effect following approval by the Mayor (or in the event of veto by the 54
Mayor, action by the Council to override the veto), a 30- day period of congressional review as 55
provided in section 602(c)(1) of the District of Columbia Home Rule Act, approved December 56
24, 1973 (87 Stat. 813; D.C. Official Code § 1- 206.02(c)(1)), and publication in the District of 57
Columbia Register. 58