The Social Determinants of Health Spending Amendment Act of 2025 aims to amend the Reasonable Health Insurance Ratemaking and Health Care Reform Act of 2010 by allowing private insurers and Medicaid managed care organizations to include certain expenditures related to social determinants of health in their medical loss ratio calculations. Specifically, the bill introduces a new subsection (a-1) that permits insurers to account for evidence-based expenditures aimed at improving the health of District residents and reducing health disparities. Eligible expenditures include initiatives addressing food insecurity, services for justice-involved individuals upon reentry, and support for continuity of care for those experiencing housing instability.

Additionally, the bill adds a new subsection (g) that defines social determinants of health (SDOH) as the conditions in the environments where individuals are born, live, learn, work, play, worship, and age, which influence a wide range of health outcomes and risks. This definition aligns with the standards set by the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention. The act will take effect following the Mayor's approval, a 30-day congressional review period, and publication in the District of Columbia Register.