B26-0024 • 2025

Social Determinants of Health Spending Amendment Act of 2025

Education Healthcare Housing

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: Henderson
Last action: 2026-03-03
Official status: Under Council Review
Effective date: Not listed

Plain English Breakdown

The official text defines SDOH but does not provide a specific list of what qualifies as 'evidence-based,' leaving some uncertainty about implementation standards.

Social Determinants of Health Spending Amendment Act of 2025

This bill changes a law to let private insurers and Medicaid managed care organizations count spending on certain social services as part of their required medical care costs.

What This Bill Does

Amends the Reasonable Health Insurance Ratemaking and Health Care Reform Act of 2010.
Allows private insurers and Medicaid managed care organizations to include specific evidence-based expenditures for social determinants of health in their medical loss ratio calculation if designed to improve District residents' health and reduce disparities.
Lists eligible spending areas including initiatives addressing food insecurity, nutrition education, services for justice-involved individuals returning to the community, and support for people with housing instability.

Who It Names or Affects

Private insurance companies operating in the District of Columbia
Medicaid managed care organizations

Terms To Know

Medical loss ratio: A calculation that shows how much money an insurance company spends on medical care compared to the premiums it collects.
Social determinants of health (SDOH): Conditions in environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, quality-of-life outcomes, and risks.

Limits and Unknowns

The bill does not take effect until the Mayor approves it (or overrides a veto), followed by a 30-day congressional review period and publication in the District of Columbia Register.
The text requires initiatives to be evidence-based but does not list specific examples of what counts as evidence.

Bill History

2026-03-03 Council of the District of Columbia LIMS
Re-Referred to Committee on Health
2026-02-27 Council of the District of Columbia LIMS
Re-Referral published.
2025-01-10 Council of the District of Columbia LIMS
Notice of Intent to Act on B26-0024 Published in the District of Columbia Register
2025-01-07 Council of the District of Columbia LIMS
Referred to Committee on Health, and Committee on Business and Economic Development
2025-01-06 Council of the District of Columbia LIMS
B26-0024 Introduced by Councilmember Henderson at Office of the Secretary

Official Summary Text

Social Determinants of Health Spending Amendment Act of 2025

Current Bill Text

Read the full stored bill text

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______________________________ ______________________________ 2
Councilmember Anita Bonds Councilmember Christina Henderson 3
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_______________________________ _____________________________ 6
Councilmember Janeese Lewis George Councilmember Robert C. White, Jr. 7
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Councilmember Matthew 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 insecurity 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