In her proposed fiscal 2026 budget, D.C. Mayor Muriel Bowser announced plans to change eligibility requirements for Medicaid in the city. It’s a plan that, if approved by the D.C. Council, could force tens of thousands of residents to move to other health care plans.
“We also have to deal with the fact that Medicaid is growing at a substantially faster clip than the city’s revenues,” said Wayne Turnage, deputy mayor for D.C. Health and Human Services.
The change in eligibility, according to the District, aims to lessen the impact of an anticipated $182 million rise in Medicaid costs.
The proposed changes would involve making childless adults and adult caregivers whose income is 138% of the federal poverty level or above, ineligible for Medicaid, which is paid for by both the city and federal government. The move is expected to impact 25,575 residents.
“When you have such cost inflation, the most pragmatic way to control costs in an entitlement program is to slow spending by reducing the number of people in the program,” Turnage said during a budget presentation Tuesday.
Turnage said D.C. Health will assist those impacted with switching to either plans on the D.C. Health Exchange or, if they qualify, to a Basic Health Plan for low-income residents.
Those moved to the health exchange may find themselves paying for premiums, though. Turnage said federal help with premiums is available for some.
“We avoid any local costs, and roughly the same coverage could be possibly available,” he said.
Mayor Muriel Bowser said the cuts in her budget come as the city faces a potential $1 billion drop in revenue over the coming years, due in part to reductions in the federal workforce.
“We think that we will be getting into an unsustainable decision-making loop of, ‘I don’t want to make hard choices,'” Bowser said.
The council will now debate the proposed Medicaid changes as part of the budget process and is set to vote on the budget by early August.
Editor’s note: The headline of the article has been corrected to the program affected in the mayor’s proposed budget.
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