The Districts Dime

ACA Repeal: Bad for Health Care, Bad for the District’s Economy

January 13th, 2017 | by Jodi Kwarciany

Repeal of the Affordable Care Act would be devastating not only for DC residents who may lose health insurance, but also for the entire DC economy. It would lead to a loss of up to 8,000 jobs in health care and beyond and $11.3 billion in business output in the District by 2023, according to a recent study.

ACA repeal chartAbout one in four jobs lost would be in the health care field, but there also would be losses throughout the private sector, including construction and real estate, retail, finance and insurance. Federal and DC government jobs would also be affected.

Shrinking support of health care would reduce DC’s business output (combined transactions at the production, wholesale, and retail levels) by $11.3 billion between 2019 and 2023. This in turn would lead to a $119 million hit to DC’s tax collections.

How does a federal health program affect jobs and state economies? By 2019, health care will be 18.5 percent of the nation’s economy. Major changes to such a large industry would affect other parts of the economy as well. When health care providers are paid for services, much of this is used for paying staff, as well buying medical equipment and supplies, or maintaining hospital or clinic facilities. In turn, this puts money in workers’ pockets that they use for goods and services that eventually become income for other businesses. Without that cash flow, it creates a ripple effect with major economic consequences.

The study, by the Commonwealth Fund and the GWU Milken Institute School of Public Health, examined the state-by-state effect of an ACA repeal on employment and economic activity. It focused on two main components of the ACA, federal premium tax credits that make marketplace coverage more affordable, and federal payments to states for expanding eligibility in their Medicaid programs.

The District has taken advantage of both. It established a local marketplace known as DC Health Link that currently serves over 21,000 individuals and more than 3,700 small businesses. It also expanded Medicaid beyond the federal requirements, covering individuals with incomes up to 210 percent of the poverty line, or $24,507 for a single person. Through these efforts, DC’s uninsured rate is now one of the lowest in the nation.

The ACA has had a positive effect on coverage gains in DC, which Mayor Bowser shared in a recent letter to Congressional Republicans urging caution on repeal. She warned that repeal could cost the District more than $600 million per year, if the city fully backfilled for lost federal assistance.

Being a national leader in expanding access to health care has been a boon to the DC economy.  It is yet another reason to be concerned about any efforts to radically scale back the health care gains brought by the Affordable Care Act.

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DC’s Health Care Exchange Is Going Strong, Amidst Federal Health Reform Uncertainty

January 9th, 2017 | by Jodi Kwarciany

“New year, new health insurance” appears to be the mindset of many District residents. New health insurance enrollment through DC Health Link– DC’s health insurance exchange– is up nearly 50 percent over the same time last year. Over 4,100 new customers completed applications and selected health plans as of December 19, compared with 2,800 new customers a year ago.

hbx-enrollment-growsThe exchange is also seeing a greater mix of ages among enrollees, which is essential for creating a more balanced risk pool and keeping health care premiums and other costs more affordable. Customers under the age of 35 make up 60 percent of this past year’s first-time customers, compared with just under half of returning customers.

These numbers will continue to grow as individuals seeking insurance hurry to finalize applications before the January 31 open enrollment deadline.

These latest enrollment numbers underscore how important having health coverage is to people who live, work, and do business in DC– and how important DC Health Link is to helping them get it. As Congress begins discussions on the future of the Affordable Care Act, District policymakers should preserve this vital resource. About 290,000 people have used DC Health Link to find insurance in the last three years, including 40,000 people purchasing private insurance through the marketplace, 176,000 who were determined to be eligible for Medicaid, and 72,000 who found coverage through the DC Health Link Small Business Marketplace (SHOP), which includes individuals in small businesses in the District and members of Congress and their staff.

With its abundant health insurance options, DC’s uninsured rate is now one of the lowest in the nation. Working to protect these gains should be a priority. Federal health reform has given consumers access to a critical set of health benefits regardless of the insurance plan they choose, including preventative and wellness services such as routine checkups or vaccinations, emergency services, maternity care, and mental health and substance use disorder services. What’s more, consumers can enroll in health plans no matter what their health status is– a key provision of health reform referred to as guaranteed issue.

Open enrollment runs until January 31 for individuals applying for private insurance, or year-round for small businesses or those applying for Medicaid. For more information, check out the Health Plan Comparison Tool for 2017, or log on to directly.


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Our New Year’s Wishes for DC

January 6th, 2017 | by Ed Lazere

2January comes, and our thoughts at DCFPI turn to — what else? — the DC budget.

We wish Mayor Bowser and the DC Council well this year as they take on the awesome responsibility of crafting a budget that meets the most important needs of DC residents, from children to seniors. Like many others, we are concerned that our new President and Congress may reduce access to health insurance and cut funding for many other services that help DC residents.

We also wish that the District can make progress, amidst this uncertainty, on these urgent challenges facing many residents:

Protecting DC’s Poorest Children: More than 10,000 children could be pushed deeper into poverty this year by a rigid time limit in DC’s Temporary Assistance for Needy Families (TANF) program. Mayor Bowser and the DC Council should work to adopt the recommendations of a Working Group convened by the DC government, which called for guaranteeing most of a family’s TANF benefit to ensure resources are always there to meet children’s needs.

Ending Homelessness: The District has made enormous efforts to reduce chronic homelessness, but keeping up with DC’s growing affordable housing crisis is hard, and many DC residents still lack a home. The District government has a goal of ending chronic homelessness by 2020, and that will require more resources in the upcoming budget.

Strengthening Access to Health Insurance: With federal health insurance coverage and protections at risk, the District should take steps to strengthen its health care infrastructure.  In particular, we should reduce barriers to getting care through DC’s health safety net program, the Healthcare Alliance.

Improving Resources to High-Poverty Schools: Schools with students who are low-income or otherwise at risk of academic failure get extra resources to address these students’ needs, but currently half of those “at risk” resources are going to fund basic positions that all schools have.  The mayor and DC Council should ensure that all schools have adequate base funding, and that all at-risk funds are available to provide additional services.

Expanding Housing Resources for Those Who Need the Most Help: A growing share of low-income renters face extremely high rent burdens, with devastating ripple effects on family finances and stability. The District is investing heavily in affordable housing, but only a fraction of the resources serve the lowest-income families. The District should expand its housing programs in ways to better reach those families.

Improving Early Education: Many of the District’s families rely on the city’s child care subsidy program to access quality child care while they go to work or pursue education. However, many early care and education providers struggle to make ends meet because of a large gap between the costs of providing quality care and resources available from the city through its subsidy program. The District should take devote more resources to the child care program to help ensure that all children get high-quality care.

Despite the uncertainty our country is currently facing, we are confident that DC can continue to improve the lives of residents by ensuring that the next budget takes these urgent needs into account.


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Remembering Our Homeless Neighbors Who Have Died, Working to Prevent Any More Deaths

December 22nd, 2016 | by Kate Coventry

Kanell Washington died this year from kidney failure, after being homeless for three decades. He had gotten a voucher to get his own apartment just a few days before he died. Kannell was an artist, a Street Sense reporter and an advocate.

Kanell was not alone. At least 46 homeless residents died in the District over the past year, most of them at a premature age. DC residents gathered this week to mark the Homeless Memorial Vigil, led by The People for Fairness Coalition, a local organization headed by individuals who have experienced housing instability. Community organizations, government officials, faith groups, and residents came together to remember those who died in the past year and to commit to ending homelessness in the District so no one dies homeless again.

Photo taken by Miriam’s Kitchen staff

Photo taken by Miriam’s Kitchen staff

Being homeless often leads to a life that is cut short. People who don’t know where they’re going to spend the night struggle to receive needed services like medical treatment or counseling. And often they are forced to stay in places that make their illnesses worse or do not keep them safe from violence. As a result, the life expectancy of people facing chronic homelessness is far shorter than for those of us who are stably housed.

This tragedy highlights the need to make further progress on the city’s plan to end chronic homelessness and to take additional steps to protect residents when they are homeless.

Among the other people who were remembered this week:

  • Enzel Sudler had a stroke. He liked to give his Miriam’s Kitchen case manager sightseeing tips as she had just moved to DC. He told tall tales and liked to make people laugh.
  •  Larry Avents had experienced homelessness off and on for 20 years. He died a week after he had been given a housing voucher. He was a good listener and a good friend.

Participants called on the mayor and DC Council to ensure that no one else dies homeless again. They urged them to fund the third year of the city’s plan to put the District on track to end long-term homelessness by 2020. The DC Fiscal Policy Institute is proud to be a part of these efforts.

Kate Coventry is a DCFPI Senior Policy Analyst and voting member of the Interagency Council on Homelessness.

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The DC Council Should Not Adopt Costly Tax Cuts For High-Income Homebuyers

December 16th, 2016 | by Claire Zippel

Why is the DC Council considering new tax breaks that would include the wealthiest buyers of the highest-priced real estate? Especially when DC already has a generous tax assistance program for first-time homebuyers covering about half of DC residents. Rather than cutting taxes for buyers of multi-million dollar homes, which would reduce funding dedicated for affordable housing, the Council could consider changes to the existing help targeted to low- and moderate-income buyers.

The District already waives the deed tax and provides a five-year property tax exemption to low- and moderate-income first-time homebuyers– for example, to a family of four earning less than $84,000 and purchasing a home worth less than $439,000. This program is well-targeted, and yet is broad enough that nearly half of all DC residents have eligible incomes, and a significant share—40 percent—of townhome, duplex, and condo sales have qualifying purchase prices.[1]

deed-tax-cut-billBut the DC Council is now considering a costly tax cut that would mostly benefit high-income buyers. The First-Time Homebuyer Tax Benefit Amendment Act would cut the deed recordation tax for people who don’t already own real estate in DC (but may own homes in other jurisdictions) in half, from 1.45 percent to 0.725 percent, for homes selling for over $400,000. For residents purchasing home for less than $400,000, the bill would cut the tax rate from 1.1 percent to 0.725 percent. Because many low- and moderate-income homebuyers already don’t have to pay the deed tax, most of the tax cut would go to buyers of high-priced homes.

The bill also would significantly reduce the city’s revenue, making it harder to fund the effort to end chronic homelessness, reform TANF, and to offset potential federal budget cuts. In particular, cutting the deed tax reduces funding dedicated to the Housing Production Trust Fund, the District’s main tool for building or renovating affordable housing and helping those with the most urgent housing needs.

The DC Council should not approve this bill. However, if the Council believes more help for first-time home purchasers is needed, it should limit new tax breaks to moderate-income families buying reasonably priced homes, such as:

  • Homebuyers with incomes below 120 percent of the area median ($128,400 for a family of four), the income level served by DC’s low-cost mortgage and down-payment assistance program, DCHFA Open Doors.
  • Homebuyers purchasing a home below the median sales price ($548,000). A maximum purchase price is needed to account for homebuyers who have moderate incomes, but who are using their or their family’s substantial to buy higher-priced real estate.

With federal budget cuts likely and DC’s vulnerable residents facing great needs, the DC Council should rethink tax cuts for high-income homebuyers, and amend or vote down the bill at its legislative session next week.


[1] DCFPI analysis of 2015 American Community Survey 1-year PUMS. 40 percent of the condos, coops, and townhomes/attached 0-3 bedroom homes sold in DC in 2015 were purchased for under $400,000. RealEstate Business Intelligence.


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