Healthcare reform can further DC's path to universal coverage

The DC Fiscal Policy Institute reported yesterday that, given the passage of national healthcare legislation, the District is taking an early advantage by opting-in to a major expansion of Medicaid.

DC has already become a nationwide leader in the push for healthcare reform: our locally-funded DC Health Care Alliance helps ensure that almost 95% of our residents are insured, the second-highest percentage in the nation.

This expansion will therefore be especially beneficial for us: with Medicaid newly available to residents with incomes below 133 percent of the federal poverty line (including childless adults), DCFPI cites estimates that 35,000 to 40,000 DC residents will transfer out of the locally-funded Alliance and into Medicaid next year.

With the passage of reform, the District can cut costs of their coverage by almost one half. The potential benefits of this development were also reported last week by the Washington Post. (But the Post article was misleading in one important respect. Tim Craig’s reporting suggested that the Alliance only covers childless adults and undocumented immigrants. In fact, the Alliance also covers many immigrants who legally reside in the U.S. but are ineligible for Medicaid due to a 1996 federal law that drastically restricts the Medicaid eligibility of lawfully residing immigrants.)

With the significant savings that DC stands to yield from Medicaid expansion, our city has a great reinvestment opportunity. The city could expand Alliance benefits for prescription drugs and specialty care to match those available through Medicaid. (As DCFPI notes, the Alliance does not currently provide strong mental health coverage.) And we could further expand eligibility for still more low- and moderate-income District residents.

This reinvestment would ensure that in the midst of sweeping healthcare reform, DC will remain at the forefront of the national trend towards universal health coverage.