Membership in the District’s low-income health care program is soaring beyond anyone’s expectations, forcing the D.C. Department of Health to divert millions of dollars and spurring D.C. Council leadership to question whether the effort is being adequately monitored.
In the last month, Mayor Adrian Fenty has sought to shift roughly $17 million into the D.C. Healthcare Alliance, the District’s locally funded safety-net program for those uninsured adults, including illegal immigrants, who earn too much to qualify for Medicaid.
Last December, the council redirected $22 million for the same purpose — to bring the city one step closer to universal health care.
The program is free to those who qualify.
The $39 million channeled into the alliance to keep it afloat came from city cash reserves, surplus revenues and unspent health department funds, according to city budget documents. Enrollment in the alliance has skyrocketed by 20,000 this fiscal year, spurring a constant need for more operating revenues.
Citing concerns about the “rapidly burgeoning” membership, Council Chairman Vincent Gray last week acted to disapprove one-third of Fenty’s most recent shifting of funds until the mayor can justify the request.
While Gray supports the alliance, “I am concerned that, as we move towards our mutually shared goal of universal health care, we prudently grow the program ensuring the availability of required resources and implementation of clear eligibility criteria,” the chairman wrote in a letter to Fenty, delivered Friday.
All D.C. residents who don’t qualify for Medicaid and who earn at or below 200 percent of the federal poverty level are eligible for alliance insurance, provided through one of two private insurance plans.
In his letter, Gray demanded an explanation for the membership increases, and he questioned whether enrollment eligibility is being properly verified.
“Expanding access is a good thing, but we also want to be fiscally responsible and make certain that only eligible persons get enrolled into the alliance,” health department spokeswoman Leila Abrar said.
The responsibility for enrolling new alliance members now is shouldered by the D.C. Income Maintenance Administration, which oversees eligibility for numerous assistance programs.
When a person calls IMA to sign up for food stamps, for example, the agency determines that person is eligible for any other programs under its jurisdiction, including the alliance.
Acting IMA Administrator Sharon Cooper-DeLoatch said her office first rules out a person’s eligibility for federally subsidized Medicaid before verifying income and residency for possible alliance membership.
