| Group |
Income Eligibility |
| Children |
200% FPL |
| Pregnant Women |
200% FPL |
| Parents |
200% FPL |
| Adults (ages 50-64; enrollment capped) |
50% FPL |
| SSI Disabled (non-elderly) |
74% FPL |
Medicaid, SCHIP, and Federal Authority2
Section 1115 Waiver - In 2002, The District of Columbia received approval from CMS to implement a Medicaid Section 1115 demonstration to provide primary and preventive health care services to non-disabled adults, between the ages of 50 to 64, with incomes at or below 50 percent FPL, who are not custodial parents or resident care takers of children under the age of 19 (i.e., childless adults). The waiver was approved for a five-year period, with an annual enrollment cap of 2,400.
Other
DC Healthcare Alliance - The Alliance provides free health care uninsured District residents with family incomes below 200 percent FPL delivered via Medicaid managed care organizations. The Alliance provides HMO-like coverage through a network of primary care "medical homes," with specialty and hospital services from participating providers. This program is funded solely by the District. However, The District has submitted a waiver application to CMS seeking federal matching funds for the Alliance. As of August 2006, Alliance enrollment was approximately 33,000 individuals.
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Information presented in the profile was summarized in December 2006 from a review of state Web sites and reports, and through contacts with state officials. In most cases the profiles were reviewed by state officials; however, it is possible that states have implemented strategies that are not reflected in this profile. |
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| 1 This overview provides a general description of state coverage levels under their Medicaid and SCHIP programs, including coverage through waivers, as of October 2006. Health Management Associates researched eligibility information from state web sites, data from state reports, and verified through contacts with state officials during the fall of 2006. This does not reflect the specific eligibility categories or requirements. This is not intended to be a substitute for eligibility information provided by each state. Individuals interested in applying for these programs should contact the state directly for specific eligibility requirements. |
2 The profile only includes Medicaid and SCHIP waivers intended to make comprehensive expansions to the uninsured. At this time, the profiles do not include Family Planning, Pharmacy Plus waivers, or long-term care waivers. |
3 Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2005 and 2006 Current Population Survey. |
| 4 Agency for Healthcare Research and Quality, Center for Financing, Access and Cost Trends. 2004 Medical Expenditure Panel Survey-Insurance Component. |
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