The District Sees Benefits from Health Care Reform
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Andrew Patterson - Staff Attorney, Public Benefits

Amidst all the dismal budget developments for our client community, here is some wonderful news.  As a result of the health care reform law (“Affordable Care Act”) signed by President Obama in March 2010, more than 30,000 District residents will be enrolled in Medicaid as of December 1, 2010.  These individuals were previously enrolled in the DC Health Care Safety Net Alliance program whose benefit package is less comprehensive than the one under Medicaid.  This expansion will also save the District millions of dollars by substituting federal for local health dollars. 

The Affordable Care Act required that states expand Medicaid access to childless adults with income at or below 133% of the federal poverty level, or about $1,200.00 per month, by FY 2014.  The District has enacted this expansion earlier than any other state except Connecticut.  Additionally, the District has also expanded Medicaid coverage to childless adults between 134% and 200% of the poverty level through a special waiver from the federal government. 

Prior to health reform, the District Medicaid program covered mainly families with children and adults with disabilities.  Although the District is one of the few jurisdictions that provides coverage to childless adults through the Alliance program, the coverage is not as expansive as that of Medicaid.  For instance, substance abuse and mental health services – crucial services for many living in poverty – are covered under Medicaid but excluded from coverage under the Alliance.  Additionally, the Alliance funded entirely with local money, unlike Medicaid in which seventy cents of every dollar spent comes from the federal government. 

Legal Aid applauds the District for swiftly moving to expand access to Medicaid and for carrying out the transition in a way that created minimal disruption in receipt of benefits.  While other states are suing the federal government and otherwise fighting implementation of this landmark legislation, the District is using it to provide a better package of health benefits to low-income residents at a lower cost.

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