The District Must Finally and Completely Eliminate Barriers to the Healthcare Alliance Program
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As the D.C. Council prepares for its first vote on the District’s Fiscal Year 2022 budget next week, Legal Aid urges Councilmembers to fund long-overdue permanent reforms to the D.C. Healthcare Alliance’s renewal policies.

The Alliance provides health coverage for immigrants living in the District with low incomes. However, for nearly a decade, the program has had application and renewal policies that make it unnecessarily hard for people to access and maintain coverage.  These policies, which went into effect in 2011, have included the requirements that Alliance participants recertify their eligibility for the program every six months and participate in an in-person interview as part of the recertification process.

Virtually every year as far back as 2012, Legal Aid has testified to the Council about the damage that the six-month, in-person recertification requirement has caused.  In the years leading up to the pandemic, we bore witness, year after year, to Alliance participants losing health coverage through no fault of their own, while others desperate to stay covered lined up at the Department of Human Service service centers at 4 A.M. or earlier just to avoid termination.  In a jurisdiction that prides itself on its high rates of insured residents, this policy singled out immigrants with low incomes for a major barrier to coverage – a glaring and unjust gap in the District’s public health policy.

When the pandemic hit, the Mayor temporarily suspended recertification requirements for a range of public benefits, including the Alliance, but disappointingly, did not fund the permanent repeal of this policy in her FY22 budget.  Unfortunately, this is the continuation of the pattern in which policymakers in the District have failed to adequately address this unfair, unnecessary, policy year after year.  The Council has twice passed legislation that would have repealed the six-month, in-person recertification requirement and replaced it with a simpler, annual renewal requirement – first in 2017, and then again last December.  Yet, the Mayor has left these bills unfunded in each of her proposed budgets for fiscal years 2019, 2020, 2021, and 2022, and the Council has not funded them either.  Indeed, the Bowser Administration could have proposed legislative and/or regulatory changes repealing the policy at any time over the last six years.

This year, instead of permanently fixing the problem, the Mayor appears to be proposing partial relief from the in-person interview requirement (allowing interviews to be done over the phone), with an offer to return to the question of full repeal a year from now when the Council considers the FY23 budget.  The Mayor’s unwillingness to provide a permanent solution to this well-documented injustice is inexcusable. District residents have waited almost a decade for reversal of this policy and should not have to wait another year.

The Bowser Administration and the Council have had years to fix this problem.  The time to act is now.  The Council should fund the Alliance provisions of Bill 23-0890, which would:

  • Replace the requirement that Alliance participants recertify their eligibility for coverage every 6 months with a requirement that they recertify annually and
  • Permanently remove the requirement that Alliance participants complete an in-person interview when they recertify.

If we value the lives and contributions of District residents who are also immigrants, we must show it by permanently by removing barriers to our friends and neighbors getting the health care they need.


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