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May 2010 St@teside

District of Columbia seeks to expand Medicaid before 2014


Earlier this month, the District of Columbia submitted a state plan amendment (SPA) to the Centers for Medicare & Medicaid Services (CMS) requesting the extension of Medicaid coverage to adults with household incomes up to 133 percent of the Federal Poverty Level (FPL) who currently do not qualify for Medicaid.  The SPA, which arises from a provision in the Patient Protection and Affordable Care Act (PPACA), will switch 35,000 enrollees currently in a District-funded program—D.C. HealthCare Alliance (Alliance)—to Medicaid. The Alliance provides basic health coverage to uninsured District residents ineligible for Medicaid but with family incomes below 200 percent of FPL, regardless of citizenship status.  Once transitioned into Medicaid, these residents will have access to a more comprehensive set of services, including mental health, long term care, and substance abuse treatment, in addition to being afforded the protections and rights conferred by Medicaid regulations. 

The move, which will increase DC’s Medicaid enrollment by over 20 percent, is projected to save the District of Columbia $56 million over four years. Julie Hudman, director of the D.C. Department of Health Care Finance, is eager to move forward on this. “Although the health reform legislation requires that states take this action by 2014, DC is not going to wait,” Hudman said.  “We started preparing for the state plan amendment as soon as the bill was signed in March and will make these changes as soon as they are possible.”  It is her hope that the expansion will receive approval and be implemented by July 1.

Connecticut was the first state to submit a SPA to CMS. The state proposed to cover adults who are currently eligible for state-funded coverage through the state’s General Assistance medical program. These adults have incomes below 68 percent of the FPL.

If approved by CMS, both expansions in D.C. and Connecticut will receive federal matching funds at the current levels until 2014, when the matching rate will increase to 100 percent.



Fears, D. “D.C. jumps at health-care savings in expanded Medicaid,” The Washington Post, May 14, 2010.