Alma Pérez* welcomed a baby boy on the Fourth of July in 2026 and named him Eduardo after his father. Eduardo is a happy and healthy baby, Ms. Pérez said, and she settled well into her routine as a first-time mom.

Ms. Pérez’s journey to parenthood was, for many reasons, a difficult road. She was uninsured at the start of a high-risk pregnancy and scared she wouldn’t be able to get the health services she needed.  

“The important thing was medical care and having insurance, because I had already lost three pregnancies — two in El Salvador, and one here in the U.S.,” she said. “I needed treatment, rest, and a lot of check-up appointments.”  

Ms. Pérez had previously received health insurance through a DC program called Alliance, which covers low-income residents who are ineligible for Medicaid. Like many members of DC’s immigrant community, Ms. Pérez had her Alliance coverage upended by DC budget cuts to the program that went into effect in the fall of 2025. These cuts, some of which have since been reversed, included tighter income limits and age restrictions. Between her job at a restaurant and her partner’s work, Ms. Pérez’s household income was slightly too high for Alliance. She was removed from her health plan and was over the age limit to reapply.

When she found out she was expecting a few months later, Ms. Pérez turned to her case manager at The Family Place, where she takes English classes. The case manager helped her apply online to another program that guarantees medical coverage during pregnancy and for two months after, called the Children's Health Insurance Program – From Conception to End of Pregnancy (CHIP-FCEP). The program is federally funded and run locally by the DC Department of Human Services (DHS).  

Ms. Pérez submitted the application and waited, her stress growing as she got closer to her due date without a clear path forward for care.  

“Those first few months, I was worried and upset. I didn’t have an OB-GYN,” she said. “I was thinking, ‘Where will I go without insurance? What am I going to do?”  

Ms. Pérez had some routine appointments at Mary’s Center and La Clínica del Pueblo, two health centers that offer care on a sliding fee scale to serve uninsured patients. But she had to cancel other services, including some ultrasounds; she couldn’t afford to pay for the scans out of pocket.

Entering her second trimester and with no updates on the status of her application, The Family Place referred her to Legal Aid DC for help.  

Agency Advocacy

Ms. Pérez connected with Legal Aid DC in March 2026, and Public Benefits Staff Attorney Lisa Meehan took her case. Two days after their first call, Lisa filed an emergency fair hearing request with the Office of Administrative Hearings (OAH) and pressed DHS for a response on Ms. Pérez’s application. They heard back within 10 days that Ms. Pérez was approved and her coverage was active.

“It wasn’t until Lisa got involved that things started moving. I thought it was strange, because we’d submitted the application back in January with the case manager, but they weren’t resolving anything,” Ms. Pérez said. “Then, once Lisa got involved, they approved my coverage going back to January.”

With her new CHIP number and assurances that coverage was in place, Ms. Pérez was able to start scheduling her appointments and catching up on care that she'd missed. Lisa also helped her get reimbursed by the Department of Health Care Finance for out-of-pocket health care costs she incurred while her CHIP-FCEP application was pending.  

“Thank God, little by little, everything fell into place. Honestly, I was so happy when my insurance came through, because the care I got was really, really good, and they took great care of my baby, too,” Ms. Pérez said. 

A Troubling Trend for Expecting Parents

Ms. Pérez’s situation was not unique. Lisa had at least three other clients in similar circumstances — including one woman whose insurance was set to be cut off the day after a scheduled induction.

Even 45 days, the timeframe DHS is supposed to have to review CHIP-FCEP applications, is too long for someone who is pregnant to wait for medical coverage. And Lisa said her clients waited far longer.  

“People like Ms. Pérez were not able to access care during their pregnancy and had to delay care or pay out of pocket,” Lisa said. “All of my clients went without insurance for the first half of their pregnancies, which is medically a very dangerous part of a person’s life.”  

Legal Aid DC saw a spike in CHIP-FCEP cases in 2025 and 2026. Lisa said that’s because previously, many eligible patients were transferred automatically from Alliance once they became pregnant.  

“When people suddenly lost Alliance and became uninsured, they had to start a separate process to apply for CHIP-FCEP,” Lisa said. “Many of those applications, which should have been timely processed by DHS, instead got lost or stuck within the agency, and people were left without insurance or medical care.”  

Effective October 2026, the DC Council reversed many of the prior cuts to Alliance, allowing many residents to regain their previous coverage. With help from her case manager Karla at The Family Place, Ms. Pérez reenrolled in the program and can continue to get the postpartum care she needs after her CHIP-FCEP coverage ended at the end of September.

Ms. Pérez said that finding advocates like Lisa and Karla helped her navigate the challenges of becoming a new mom during a difficult time.  

“Because of the circumstances we’re living in these days, you feel afraid. You think no one will stand by you, that there might not be anyone who can help,” Ms. Pérez said. “But I really appreciate the help I received, and I’m very grateful, because it’s been a wonderful experience.”  

*Names have been changed to protect client’s privacy