D.C. City Council Hearing on the Implementation of Healthy D.C.

by Tamar Zaidenweber

On Thursday November 12, DC City Council member David Catania, Chair of the Committee on Health, hosted a roundtable hearing on the implementation of Healthy DC. The City Council passed the Healthy DC legislation in 2008, which created an extensive expansion of the Medicaid and DC Alliance programs that will be available to DC residents with household incomes up to 400% of the federal poverty level (FPL) who do not qualify for any other public insurance program. The District’s goal is to move toward universal coverage, without waiting for the Federal Government to require it, and Healthy DC is the next step in that process.

The Council roundtable included two witnesses: Tona Vidal-Kinlow, Vice President of Government Affairs at CareFirst and Dr. Julie Hudman, Director of the DC Department of Health Care Finance. Dr. Hudman presented testimony outlining the current status and structure of the Healthy DC program, the benefit, and the steps to implementation.

The Healthy DC benefit will be structured as a government subsidized insurance buy-in program available to the uninsured population of DC up to 400% of the FPL, allowing them a chance to participate in the health insurance system. The uninsured population in DC, at all income levels, is estimated at about 59,000, according to Dr. Hudman’s report. Healthy DC was created to fill in the gaps within the ranks of the District’s uninsured.

The benefit structure will be comparable to those offered by private plans, but with heavily subsidized premiums, modest co-payments and cost sharing, all of which were indicated in Dr. Hudman’s testimony.

In Dr. Hudman’s presentation to Councilmember Catania, she discussed the steps involved in implementing the Healthy DC Program. At present, Healthy DC is negotiating with the existing Medicaid Managed Care Organizations, and expects to finalize and sign contracts in December. The timeline proposed indicates that coverage is expected to begin in April 2010.

As the Councilmember mentioned, “while the rest of the country seems to be struggling to keep their head above water, we are in the enviable position of looking to further expand the ranks of the insured.” Though the District is facing budget pressures, Councilmember Catania is very dedicated to the future of Healthy DC.

In Ms. Vidal-Kinlow’s testimony and subsequent discussion with the Councilmember , she discussed the $5 million one-time payment that CareFirst is making to the District of Columbia with the intention of it being used to expand insurance coverage. Later, the Councilmember agreed “to at least match the resources coming from CareFirst,” which would bring the budget for this year to $10 million and cover thousands of individuals.

It is clear from this roundtable discussion and previous statements that Councilmember Catania is very dedicated to seeing Healthy DC start providing coverage to the next segment of the population with the goal of universal coverage on the horizon.

To watch the hearing, please see: http://oct.dc.gov/services/on_demand_video/channel13/november2009/11_12_09_HEALTH.asx

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