Testimony of Rachel Metz, Research and Data Manager before the Committee on Health 03-04-2021

March 4, 2021
Person Testifying: Rachel Metz
Title: Research and Data Manager , DC Action
Testimony Heard By: Before the Committee on Health
Type of Hearing: Performance Oversight Hearing Fiscal Year 2021

Good morning, Councilmember Gray and members of the Committee on Health. Thank you for the opportunity to address the Council as it reviews the Fiscal Year 2021 performance of the Department of Health Care Finance. I am Rachel Metz, Research and Data Manager of DC Action.

DC Action uses research, data, and a racial equity lens to break down barriers that stand in the way of all kids reaching their full potential. Our collaborative advocacy initiatives bring the power of young people and all residents to raise their voices to create change. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child and youth well-being.

Chair Gray, we want to thank DC Council and Mayor Bowser for your fast commitment to ensuring that DC residents who use public health insurance programs such as Medicaid, DC Healthy Families, the Healthcare Alliance, and the Immigrant Children’s Program were able to continue receiving benefits during the COVID-19 pandemic without taking further action to recertify. Once recertification resumes, however, some families may be shut out. We have recommendations for follow-up actions to ensure that DC’s children and families have consistent access to the health care they deserve.

  1. Continuous Eligibility for Children

Children in families whose incomes fluctuate above and below the income cut-off for Medicaid or Healthy Families risk losing access to care. Particularly because employment may be unstable for some families as the economic effects of the pandemic linger, District leaders should provide children with 12 months of continuous health coverage even if families experience a change in income during the year.

  1. Extend Alliance Recertification Period to 12 Months

Last year DC Council took two helpful steps to make recertification in the Health Care Alliance less of a barrier. First, by allowing recertification to be completed by phone once a year in addition to in-person once a year. Second, by passing Bill 23-890, which would make recertification annual and eliminate the in-person requirement altogether. Thank you to the Chair and other members of this committee who played a vital role in passing this legislation. Now we call on the Council to fund it.

In the Financial Impact Statement for that legislation, the Office of Revenue Analysis estimated that DHCF can absorb the cost of this change in fiscal year 2021 but will need an additional $34.85 million beyond existing Alliance funding in the 2021-2024 financial plan to implement the bill. Given that enrollment has not skyrocketed during the period during the pandemic in which recertification is waived, it may be possible to absorb more of the cost than was forecasted several months ago when less information about pandemic-era enrollment was available.

  1. Health Coverage for Postpartum Parents

Continuing the pattern of DC Council passing helpful legislation that we now encourage you to fund, we appreciate you passing B23-0326, the Postpartum Coverage Expansion Amendment Act of 2019. This legislation says that DC’s Medicaid program will apply for a waiver to cover inpatient and outpatient maternity and newborn care for at least one year after childbirth. It is estimated to cost $5.21 million – of which $1.69 would be local funds – over the FY 2021 through 2024 financial plan. While hopefully Congress will step up and provide a 100% federal matching rate, unless and until it does so, the District should fund this expanded coverage for postpartum parents. This modest annual investment would help improve the safety net for new parents who already face so many challenges.

  1. Maximize program flexibility

During the pandemic, the District wisely took advantage of increased federal flexibility to provide telehealth services, and some providers found that this policy reduced transportation and other barriers to historically underserved populations accessing care – particularly mental health care for which people may otherwise fear a stigma. By allowing telehealth to be reimbursable after the public health emergency to the full extent allowed by federal policy, the District can continue this benefit.