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Organizations Decry Health Inequities in FY 2020 DC Budget, Call on Council and Mayor to Not Pit Health Programs Against Each Other

Eight organizations that work on health equity and workers’ rights sent a letter today to Mayor Bowser and the DC Council, criticizing actions to cut support for United Medical Center in the DC budget for fiscal year (FY) 2020, as well as the budget’s continued neglect of immigrants seeking care through the DC Health Care Alliance program. The groups particularly called out the DC Council for pitting funding for these two important programs against each other.

The just-adopted budget provides $22 million to support operations at UMC. While this is a substantial increase from the Council’s initial $15 million support, it is well below the level needed to maintain a full set of acute care services. The cut to UMC puts the survival of UMC—the only hospital in the eastern half of DC following the closure this year of Providence Hospital—at risk, and threatens elimination of hundreds of good quality jobs, held primarily by people of color.

In the DC Healthcare Alliance, there is broad acknowledgment that a burdensome requirement to renew eligibility every 6 months in person leads to a high rate of turnover or “churn,” because working residents can’t afford to take a day off just to show DC government that they remain eligible. This means that thousands of eligible residents have only intermittent health care coverage, at best, leading to poor health outcomes and higher health costs for the city.

The eight organizations that sent the letter, along with Reverend Graylan Hagler, particularly decried the Council for pitting the Alliance and UMC against each other. When the Council cut the UMC subsidy, they shift some of the savings to the Alliance. But in the final budget vote on May 28, the Alliance funding was pulled back and shifted to UMC.

“Pitting two safety net health care programs—and two communities—against each other is shameful,” said Ed Lazere, Executive Director of the DC Fiscal Policy Institute, one of the signers. “The health of residents east of the Anacostia River should not come at the expense of immigrant health.”

The groups called on DC’s leaders to commit to full and equitable health care access for all DC residents, and that means fully funding both UMC and the Alliance.

The full letter is attached to this release.

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June 26, 2019

To Mayor Bowser and the DC Council,

 

In a city marked by vast differences in health outcomes by zip code and race, the District has an obligation to ensure that all residents have convenient access to high-quality health care.  We are concerned that the just-completed budget for fiscal year 2020 represents a step backward in health equity in two important ways.  First, despite important last-minute funding identified by the DC Council, the lack of full support for United Medical Center, DC’s safety net hospital, puts the health of DC residents living east of the Anacostia at risk.  Second, the failure to remove barriers that DC imposes on residents who get care through the DC Healthcare Alliance—nearly all of whom are immigrants—means that thousands of residents will continue to have only intermittent access to primary and preventive health care or none at all.

As the DC Council takes the important step to make racial equity a core focus of DC Government, through the Racial Equity Achieves Results legislation now under consideration, maintaining UMC and strengthening the Alliance are critical to racial equity in health care.

The just-adopted budget provides $22 million to support operations at UMC.  While this represents a substantial and much-needed increase from the Council’s initial $15 million support, it is well below the level needed to maintain a full set of acute care services. Residents living on the eastern half of the District already are suffering from the closure of Providence Hospital this year and the closure of UMC’s obstetrics unit in 2018.  Investing in UMC until a new hospital is open is critical, and we urge the mayor and Council to fully support the hospital in 2020—adding funds needed to maintain current services—and every year until the new hospital is ready.

In the DC Healthcare Alliance, there is broad acknowledgment that current program rules—particularly a requirement to renew eligibility every 6 months in person—leads to a high rate of turnover or “churn,” because working residents can’t afford to take a day off just to show DC government that they remain eligible. This means that thousands of eligible residents have only intermittent health care coverage, at best, leading to poor health outcomes and higher health costs for the city. It is shameful that the District applies a more restrictive and punitive set of rules to immigrants seeking health care than to other DC residents; no other DC program requires 6-month renewals. In 2017, the Council adopted legislation to eliminate these barriers. But neither the Mayor nor the Council has committed the funding needed to make this a reality.

During the FY 2020 budget debate, the Council pitted the Alliance and UMC against each other unnecessarily and shamefully. When the Council cut the UMC subsidy to $15 million, some of that savings went to a $2.5 million down-payment to increase access to the Alliance. But in the final budget vote on May 28, the $2.5 million was pulled back and shifted to UMC, dashing the hopes of Alliance participants that the Council finally was making progress to help them.

Pitting two health care programs and two communities against each other is wrong. The health of residents East of the River and much needed support for UMC should not come at the expense of immigrant health and improving health care provided by the DC Healthcare Alliance. DC’s leaders should be committed to full and equitable health care access for all DC residents, and that means fully funding both UMC and the Alliance.  That is what we call on the Mayor and Council to do, now.

Signed by:

DC Fiscal Policy Institute

DC Jobs with Justice

District of Columbia Nurses Association

La Clinica Del Pueblo

Legal Aid Society of the District of Columbia

Mary’s Center for Maternal and Child Health

Unity Health Care

Whitman Walker Health

Rev. Graylan Scott Hagler, Pastor, Plymouth Congregational United Church of Christ

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