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Hello Chair Gray and members of the Committee on Health. Thank you for the opportunity to address you today. My name is Rachel Metz, and I’m the Data and Research Manager at DC Action.
We want to thank this committee and DC Council as a whole for steps you took last year to increase access to public health insurance programs. By funding the Postpartum Coverage Expansion Amendment Act, subsidizing transportation to postpartum health care appointments, and allowing recertification in the Healthcare Alliance to be done entirely by phone - at least for this year, you’ve helped to reduce some of the barriers that stand in the way of health care for District families. Thank you to the Chair and other members of this committee who played a vital role in funding these priorities.
While these were important steps, we remain concerned, as we know you do, about the hurdles that many families faced with the Alliance once recertification requirements resumed. As we all learned when CityPaper reported on an email from Deputy Mayor for Health and Human Services Wayne Turnage, 7,000 Alliance enrollees - one in three - were decertified this fall due to backlogs and other administrative challenges at DHS. Though most were reinstated, the confusion and delays left District residents scrambling to address time-sensitive health needs. We’re especially concerned about the potential impact on those who may have missed out on important pre- or post-natal care. While it was a positive move for DHS to reinstate these program participants, it’s clear that a longer-term systemic solution is needed.
The DC Health Care Alliance needs to switch back to an annual enrollment. Switching to annual enrollment will not only reduce DHS’ administrative burden, it will also align the program with other health insurance programs. We know that the switch to six-month certification resulted in a drop of nearly one-third of the enrollees. A decade later, with community members as well as health care and legal providers testifying each year about the negative impact of frequent recertification, it’s past time to change it.
Even if we were to resolve the administrative challenges and create a smooth and efficient recertification process - which we haven’t done for over a decade now - there’s still a basic equity question that we must all face. Why does the District require twice annual certification in a program that is doing the important work of addressing the needs of many immigrant residents who have limited access to health insurance? What purpose does it serve when other health programs don’t require twice annual certification? And, if we are able to answer that last question, does that purpose outweigh the cost of having many vulnerable people lose the benefit due to administrative challenges that have nothing to do with them? We all know that the reason District leaders instituted the Alliance in the first place is due to the xenophobia embedded into federal polices that make many immigrants ineligible for federal benefit programs including Medicaid. Its existence addresses a racial equity issue: roughly half of Alliance participants are Latinx and just under one-fifth are Black. Let’s stop the double standard in how often these District residents need to recertify compared to those who are able to enroll in Medicaid instead.
We hope that the Council will stand by its legislation and provide funding so that District residents only need to recertify annually for public health insurance programs, regardless of which program it is.
February 28, 2022