State Expansions: District of Columbia
In 2001, in order to expand coverage for non-disabled, childless adults, Washington, D.C. created the DC HealthCare Alliance, a program that provides limited coverage to this population through hospitals and community clinics. The program is available to adults with incomes of up to 200 percent of poverty ($21,660 for an individual in 2009).
In 2006, D.C. expanded income eligibility for Qualified Medicare Beneficiary (QMB) benefits to 300 percent of poverty ($34,490 for an individual in 2009). QMB benefits help low-income individuals pay for Medicare premiums, deductibles, and copayments. People who are eligible for QMB benefits are also automatically eligible for Medicare Part D low-income subsidies. For more information, see Good Ideas: How Medicaid Agencies Can Help People Enroll in Medicare Part D Low-Income Subsidies.
Effective April 2007, D.C. expanded Medicaid and CHIP eligibility to children with family incomes up to 300 percent of poverty ($51,510 for a family of three in 2007). The District also added dental care to its Medicaid benefit package for adults.
In 2008, the District passed new legislation establishing Healthy DC, which will provide subsidized coverage for residents with incomes up to 400 percent of poverty ($70,400 for a family of three in 2008) who either have no coverage, or have received an unaffordable offer of coverage from their employer. The law limits premiums to 3 percent of income and sets a floor on benefits. However, implementation of the program has been delayed for at least a year due to fiscal constraints.
In December 2008, the District passed the Medical Insurance Empowerment Act of 2008, which requires that any surplus held by its not-for-profit insurer be spent on community health benefits or premium reductions for enrollees, restores the not-for-profit insurer's obligation to sell policies to everyone regardless of health status (referred to as open enrollment), and forbids the not-for-profit insurer from ever converting to a for-profit entity. However, implementation of the open enrollment provision has been delayed by an emergency resolution passed by the Council of the District of Columbia on April 7, 2009.
District of Columbia Expansion Resources
For general resources on state expansions, see Other Resources.
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