Many District residents face persistent health problems, with low-income communities facing particularly high rates of severe and chronic illness. To improve residents’ health, the District needs policies that ensure residents get the health services they need, that guarantee high quality care from the managed care companies paid by the city to provide health care for hundreds of thousands of low-income residents, and that create sustainable funding for public health insurance programs.
Over the past 15 years, the District has taken several steps to expand access to affordable health care. But that has not been enough to result in dramatic improvements in the health of DC residents. DCFPI’s health policy transition brief details three ways Mayor Bowser and the DC Council can create a more effective and sustainable health care system. Here’s how:
- Make it easier for eligible residents to enroll in the Healthcare Alliance program. The DC Healthcare Alliance provides health insurance to 14,500 low-income residents who are not eligible for Medicaid or Medicare. However, stringent application rules make it difficult for eligible residents to keep the insurance and have contributed to a sharp drop in people enrolled in the Alliance. The District should align Alliance’s application requirements with Medicaid, which will help more eligible residents get benefits and reduce the likelihood that hospitals and other provides will provide uncompensated care to uninsured residents.
- Increase Oversight of Medicaid Managed Care to Improve Outcomes and Access. The District could better connect residents on Medicaid with basic health services, which would improve health and avoid use of costly services that do not improve patient care. The District uses a managed care approach for 175,000 Medicaid beneficiaries, or about a quarter of the District’s residents. But there is limited oversight and few performance standards for the companies contracted to provide this care, and, as a result, health disparities persist. Stronger oversight, contract stipulations, and performance evaluation are needed to ensure that residents are getting access to the best care possible.
- Improve Sustainable Sources of Local Financing for Medicaid. Across the country, states are increasingly using taxes on health care providers to draw down billions in federal Medicaid funds, yet the District has reduced its provider tax collections. Strengthening DC’s health provider taxes makes sense for a number of reasons, particularly that every $1 in taxes results in over $2 in federal funds to health services. Health provider taxes also could help the District prepare to sustain Medicaid if the new Congress seeks to cut federal funding.
To read a full copy of this transition brief, click here.
To print a copy of today’s blog, click here.
