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A Plan of Action to Confront Expected Massive Loss of Federal Health Care Funds Not Apparent

In this space last month we quoted Ward 2 Councilmember Jack Evans’ sobering, worse case assessment that the District “would face enormous financial shortfalls if the Trump administration and Congress move forward with any of their proposals to . . . repeal the Affordable Care Act (ACA), or significantly change the Medicaid funding formula.” He further shared with us that Auditor Kathy Patterson had “recently estimated that the repeal of some or all of the ACA would cost the District at least $1 billion annually in lost insurance coverage for our residents.” Evans know of what he speaks; his expertise is based on his having chaired the Committee on Finance and Rvenue for many years.

To date we have not seen much evidence that our leaders are anywhere near coming up with a plan to confront this very real probability — other than some hand-wringing entreaties to Republicans not to do what they are clearly in the process of doing.

We were, however, encouraged that at least one of our leaders has taken a stab at coming up with a start of a plan. We are referring to former Mayor Vince Gray who is now not only once again representing Ward 7 on the City Council but also heading up the Council’s very important Committee on Health.

And it was in that capacity during his committee’s March 8th public hearing that, as reported the next day by the Washington Business Journal, that he urged the Mayor “to set aside $159 million in the upcoming budget to create a fund that would protect against the potential repeal of the Affordable Care Act.”

Further, as reported, “Gray said the city should create the reserve to protect District residents from the ‘deep uncertainty’ caused by health care debates in Congress. He said he is proposing the use of surplus funds for health care before it can get earmarked for something else.” (Italic ours; as we have observed in past editorials, we’ve never met — with rare exceptions like finance committee head Evans or Chairman Mendelson — members who never encountered a surplus dollar they didn’t desire to spend on a pet project.)

In her early January letter to key Republican members of Congress, the Mayor stated that the repeal of the ADA and the resultant loss of funds to the District would mean an annual loss of upwards in excess of $600 million now used to fund health programs, including Medicare.

Additionally, according to the Journal, “There are about 19,000 people who’ve purchased private health insurance through D.C. Health Link, the District’s exchange created under the Affordable Care Act. More than 60,000 people are insured under the SHOP, or D.C. Health Link’s small business exchange. . . .”

Vince Gray’s proposal to immediately “sequester” — our word, because that seems to be his intent — is in our view an important first step to ensuring a goal of identifying further sources of funds. We strongly urge the Mayor to follow this suggestion as she finalizes her soon-to-be submitted budget proposal to the Council. And, if she does not do this, then the Council must do it.