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District of Columbia

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Medicaid, SCHIP, & Federal Authority

  • Section 1115 Waiver –  In 2002, The District of Columbia received approval from the Centers for Medicare and Medicaid Services (CMS) to implement a Medicaid Section 1115 demonstration for District residents between the ages of 50 and 64, with incomes at or below 50 percent of the federal poverty level (FPL). This demonstration uses the same benefit package as the District’s current Medicaid managed care program delivery system. The waiver was approved for a five-year period, with an annual enrollment cap of 1,358 individuals.

State Specific Strategies

  • DC Healthcare Alliance – The Alliance provides health care to uninsured District residents, regardless of citizenship status, who are ineligible for Medicaid with family incomes below 200 percent of the FPL delivered via Medicaid managed care organizations. The Alliance provides HMO-like coverage through a network of primary care “medical homes,” with specialty and hospital services from participating providers. This program is funded solely by the District. As of December, 2008, Alliance enrollment was approximately 49,500 individuals.