What are the barriers in Washington DC?

District residents are eligible for a city-funded health insurance program, the DC Health Care Alliance. Those who qualify are not eligible for Medicaid or do not have private insurance. Many are immigrants and receive care at health centers like La Clínica Del Pueblo. Unlike the yearly renewal of Medicaid, Alliance beneficiaries must recertify every six months at centers that may lack bilingual staff or on-site interpreters.

Due to long lines, some recipients have lost income from hourly wages. Others have lost coverage if they cannot be seen or take the day off from work. During COVID, mandatory in-person requirements have been waived and on-line applications have been made available. However, requiring two recertifications a year by any means still creates barriers to access due to busy phone lines, poorly translated information, and excessive documentation requirements.

What is the impact of NOT having an annual recertification for the DC Alliance Program?

• Loss of income: Losing a day of work due to long lines when renewing in person or waiting by the phone.

• Partial Coverage/ Interruptions in Care: Many people go without insurance coverage during the renewal process, thus interrupting their medical care or access to medications.

• Technological Solutions ≠ Increased Health Access: A transition or future reliance on online and telephone systems may exacerbate existing inequalities in accessing health care. Older people, those with no educational qualifications, people whose first language is not English, and people with literacy problems or learning disabilities are least likely to engage with digital communication.