The Healthy DC Program was created as part of the Fiscal Year 2009 Budget Support Act of 2008 which passed District of Columbia Council on June 3, 2008. The passage of the Healthy DC Program reflects the commitment of Councilmember David Catania (Independent-At-Large), Chairman of the Committee on Health to move the District closer to universal coverage for all District residents by providing affordable, accessible, and comprehensive health insurance benefits for eligible District residents.
The Healthy DC Program builds upon the successfully prior investments in Medicaid and The DC Healthcare Alliance and will make the District of Columbia a leader among the states in providing meaningful health insurance to its residents.
Eligibility
Designed to reach those uninsured District residents who do not qualify for Medicaid or The DC Healthcare Alliance, Healthy DC will be available to eligible District residents who reside in households earning between 200 % of the federal poverty level (FPL) and 400 % FPL. For a family of four, Healthy DC will provide meaningful health insurance coverage for households that earn between $42,400 and $84,800 per year. The legislation requires that eligible individuals be uninsured for a period of 6 months prior to applying for Healthy DC, but exempts this requirement for a series of life changing events.
Funding
Healthy DC is based on a shared responsibility model between the District of Columbia and the individual enrollee. Enrolled individuals will contribute no more than 3 % of their gross income toward Healthy DC. To assure that funds are continually available to support Healthy DC, the legislation directs tax revenue collected from the 2.0 % premium tax on health insurers plus 75 % of the 2.0 % premium tax collected from Health Maintenance Organizations into the Healthy DC Fund. For maximum flexibility, the Healthy DC Fund allows for the deposit of additional monies to support the program.
Implementation
Healthy DC directs the Mayor and the Department of Health Care Finance to make the program available to eligible individuals by July 1, 2009. The Mayor is authorized to enter into a contract with one or more health insurance insurers to implement Healthy DC.
The Act also increases the reimbursement rates paid by the District’s Medicaid program to equal those paid by the Medicare program. Currently, Medicaid reimburses physicians at a much lower rate than Medicare. The result is that many healthcare providers choose not to participate in the Medicaid program, leaving low-income residents with few options for care.
