The District’s fiscal 2010 budget proposes to slash spending on the D.C. Healthcare Alliance, the city’s nearly universal health care program, by cracking down on participation by non-city residents and shifting thousands more enrollees to Medicaid.
The D.C. Council’s health committee, chaired by Councilman David Catania, on Wednesday approved a $102.25 million budget for the alliance, a proposal that assumes 45,960 participants. It is a nearly $12 million cut from the program’s 2009 allotment and features a projected reduction of roughly 4,400 enrollees.
The fledgling Department of Health Care Finance, a $2 billion operation, now has oversight of Medicaid and the alliance. The agency provides health coverage to roughly 200,000 D.C. residents, or about 33 percent of the population.
The alliance is at the heart of the District’s health care safety net, providing free care to those D.C. residents, including illegal immigrants, who are not eligible for other benefit programs such as Medicaid. But an audit of enrollment released early last year found thousands of ineligible people had gained access, costing taxpayers millions.
Alliance enrollment reached 49,851 as of January. The council and Mayor Adrian Fenty are proposing to cut that to 45,960 in 2010.
Enforcing the existing residency requirement will chop 6,800 members, saving $13.6 million. Another 723 people who are eligible for other health insurance will be moved out of the alliance, saving $2 million. The city also plans to use $13.7 million in federal funds to transition eligible residents into Medicaid, cutting alliance enrollment by another 4,130 members. And moving unborn children of undocumented immigrants to Medicaid will save another $788,234.
“These savings initiatives protect the program and promote its long-term sustainability,” Dr. Julie Hudman, director of the health care finance office, told Catania’s panel earlier this month.
Thousands of alliance members were suspected of living outside the District but taking advantage of free D.C. health care, last year’s audit found. Hundreds of others were found to be in the program past their 65th birthday, when they should have been shifted to Medicaid. As of November 2007, for example, there were 166 U.S. citizens in the Alliance over 65, include 33 who were older than 70.
