Access to Health Care
I have seen firsthand the problems that result from people staying in shelters and not receiving the medical care they need. In my own experience as a diabetic living in the Federal City shelter known as Second and D, it was very difficult for me to receive the medical help I needed. If people are not near death, they are ignored. – Carl S., SOME Client
Inadequate access to essential health care is a major problem in D.C., as it is nationwide. The problem is particularly acute for homeless and low-income residents. Lacking access to regular medical and dental care, they are more likely to develop urgent health problems that require emergency treatment. They are also more likely to die from conditions that could have been treated if caught at an early stage.
- The infant mortality rate in the District is twice the national average.
- D.C. mortality rates for many forms of cancer are the highest in the nation—including cancers that are often treatable if detected in time.
- Hospital admissions that could have been averted are higher in D.C. than almost anywhere else in the country.
D.C. Government Response
The D.C. Government has taken some important steps to meet the essential medical and dental care needs of its homeless and low-income citizens. It has created a program—the DC Healthcare Alliance—to provide health insurance to low-income residents who are not eligible for Medicaid. It has also expanded its Medicaid program to cover more low-income children and dental care for adults. The Fiscal Year 2009 budget will fund affordable health insurance to additional low-income residents.
SOME advocates continued full funding for the DC Healthcare Alliance. The District's Fiscal Year 2008 budget took an important step toward universal healthcare insurance coverage by providing the DC Healthcare Alliance with sufficient funds to cover the estimated number of residents who are eligible to participate. The Mayor and City Council must ensure that the Alliance remains able to cover their healthcare needs and the needs of additional residents who may enroll.
Continuing Access Problems
Low-income residents still have less access to medical and dental care than the rest of the population. One major reason for this is that relatively few healthcare practitioners—particularly, specialists—will treat low-income patients because the reimbursement rates under Medicaid and the DC Healthcare Alliance do not cover the actual costs of care. Reimbursement rates under the Alliance are the same as when the program was established seven years ago, despite escalating costs.
SOME advocates increased funding to increase reimbursement rates under the DC Healthcare Alliance. Reimbursement rates under the DC Healthcare Alliance have not been increased since the program was established in 2001. Costs of providing medical care are much higher now. Even with the increase mandated for next year, the reimbursement rate for a primary care visit will cover barely 50% of providers' costs. The District relies on nonprofit community health centers to serve residents enrolled in the Alliance. Centers cannot expand—indeed, may need to severely cut back on services unless the District closes the gap between reimbursements and operating costs.
Resources
Facts & Figures
Research Summary
Issue Papers
Recent SOME Testimony
Additional Resources
