DC has been a pioneer in health care coverage. Only six percent of District residents — 37,000 people — lack health insurance. However, the official number of uninsured may not accurately reflect the number of people struggling to get the care they need. That is why local programs targeting populations who fall through the cracks, such as the DC Healthcare Alliance, are important even in the age of Obamacare. Expanding the Healthcare Alliance could get DC as close as possible to universal health insurance coverage.
Even with the Affordable Care Act’s expansion of Medicaid and the health care exchange, there are still residents who will remain without coverage. That’s not healthy for these families or for our city.
The Alliance, a local program, is a critical source of health care for DC residents that fills in some of the gaps left by the Affordable Care Act. Residents with income below 200 percent of the federal poverty line who do not qualify for Medicaid or Medicare can get access to doctors and other providers through the Alliance. Many of these residents are undocumented, which is the reason why they cannot access federal programs like Medicare, Medicaid, or subsidies through DC Health Link.
But gaps remain, and expanding the Alliance could bring DC closer to universal health insurance coverage. Federal health reform targets assistance to make health care affordable to households below 400 percent of poverty, but as noted, the Alliance stops coverage at 200 percent of poverty.
The District could ensure that all residents who need help paying for health insurance get it by expanding eligibility of the DC Healthcare Alliance up to 400 percent of the poverty line. Like DC Health Link, residents could partially pay for their health insurance and the District could provide subsidies based on income. The Alliance subsidy could slowly phase out as one’s income increased from 200 to 400 percent of poverty.
An expanded Alliance program could help a great number of workers who contribute to the economic success of the city but receive little, if any, assistance from the District. The expansion would create equity in DC’s efforts to expand access to care and create a healthier workforce and citizenry. That’s in the best interest of every DC resident.
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