Testimony of Shana Bartley, DHCF Performance Oversight Hearing, FY 2016-2017

Testimony of Shana Bartley, DHCF Performance Oversight Hearing, FY 2016-2017

Testimony of Shana Bartley, Acting Executive Director

DC Action for Children

 

Agency Performance Oversight Hearing

Fiscal Year 2016-2017

Department of Health Care Finance

 

Before the Committee on Health

Council of the District of Columbia

 

March 8, 2017

 

Good morning Councilmember Gray and members of the Committee on Health. Please accept my written testimony as it reviews the performance of the Department of Health Care Finance (DHCF) for Fiscal Year 2016. My name is Shana Bartley, and I am the Acting Executive Director of DC Action for Children (DC Action).  

DC Action provides data-based analysis and policy leadership on critical issues facing DC children and youth. We are also the home of DC KIDS COUNT, an online resource accessible to policymakers and community members alike that tracks key indicators of child well-being in the District. We work closely with city agencies, the school system and service providers to share the most accurate and timely data, along with clear and accessible analysis. Our advocacy agenda is based on these data.

The accomplishments that the District of Columbia has achieved in securing health coverage for children cannot be overstated. DC has and continues to be a leader in the nation, ensuring that 98% of children in the District have health insurance coverage.[1] This impressive feat facilitated by DHCF, in partnership with other city agencies, is realized in large part by public insurance programs including Medicaid and the Children’s Health Insurance Program (CHIP), as 46% of all children in the District are ensured through these two programs.[2]

Thousands of children in the District rely on Medicaid and CHIP in order to grow up healthy and reach their full potential; 83,099 children were enrolled in Medicaid in September of 2016, and 11,753 children in CHIP.[3] Notably, not only do these programs provide children with care when they are sick, but Medicaid and CHIP also cover an array of preventive services through its Early and Periodic Screening, Diagnostic and Treatment (EPSDT). We know that investing in preventive care for children whose parents would not otherwise be able to afford it not only leads to better outcomes for children, but also makes strong fiscal sense.

 

In light of recent federal policy changes that could have devastating effects on children’s health insurance rates, the work of those committed to equitable access to health care is more important than ever before. We are heartened to know that DHCF joins us and other advocates in recognizing not only the fundamental importance of ensuring that all children have access to health care, but also in recognizing the high stakes and potential sweeping repercussions that the proposed federal legislation can hold for DC children and their families.

In FY16, we saw DHCF continue its commitment to improving agency performance in numerous ways:

  • Led by DHCF, the District is a national leader in ensuring children have access to insurance. As a result of the District’s leadership and commitment to providing insurance coverage for children through CHIP and Medicaid, only 2% of children are uninsured.[4] CHIP and Medicaid serve children in the District with the fewest resources, as 90% of children living in or near poverty, 60% of children with disabilities or other special health care needs and 100% of children in foster care participate in one of these public programs.[5]
  • In order to best serve residents, DHCF remains committed to addressing technical challenges with the build out of the DC Access System. DHCF has been tirelessly working to construct a seamless integrated system to allow all residents to do one-stop shopping for all services. This integrated eligibility system will offer children and families covered by Medicaid an efficient vehicle to both apply for and renew their coverage to the program

DC Action has been a member of the DC Medical Care Advisory Committee (MCAC), serving alongside other advocacy organizations, Medicaid consumers, health care providers and other Medicaid stakeholders. The successful functioning of this committee and the functioning of the Medicaid program could not be possible without the commitment to transparency and collaboration that Director Turnage and his staff consistently demonstrate. Given this consistent commitment to best serving DC children and families, we are confident that DHCF and its sister agencies will respond competently and creatively to ensure coverage for District residents who would otherwise not have access.  

However, I do not want to understate the potential harm of federal threats to the District’s achievements above. We continue to follow the developments on Capitol Hill and the looming threats to the Affordable Care Act. Both repeal of Medicaid expansion and changes to Medicaid financing create serious threats to the health and well-being of all residents of the city, not just those who rely on public insurance programs for coverage. We are grateful that you, Chairman Gray, and other members of the DC Council are asking important questions about the potential impact of federal changes. The District’s children depend on our public insurance programs and we must do all that we can to ensure that Medicaid remains an entitlement so that children have access to care that is critical for them to reach their full potential. While we are confident that DHCF and its sister agencies would adapt to a new health care landscape because of changes to the ACA, the proposed federal law would place significant constraints on how we are able to serve District residents including children. The law should be challenged proactively so that the District does not have to compromise on eligibility or benefits in reaction to the damaging changes. We call on the Council and our adovcacy partners to follow the federal developments and prepare to defend our public insurance programs.

Thank you for the opportunity to testify today, Chair Gray. I am happy to answer any questions that you may have.

 

 

 

 

 

 

[1] Data via DC KIDS COUNT; Children Without Health Insurance. Source: American Community Survey, 5 Year Estimates. http://datacenter.kidscount.org/data/tables/8810-children-without-health-insurance?loc=10&loct=3#detailed/3/10,55-56,58-61,64-7…

[2] Georgetown Center for Children and Families. District of Columbia Snapshot of Children’s Coverage (2017).

[3] Department of Health Care Finance (2017). FY16 Performance Oversight Binder 1, Part 1.

[4] Data via DC KIDS COUNT; Children Without Health Insurance. Source: American Community Survey, 5 Year Estimates. http://datacenter.kidscount.org/data/tables/8810-children-without-health-insurance?loc=10&loct=3#detailed/3/10,55-56,58-61,64-7…

[5] Georgetown Center for Children and Families. District of Columbia Snapshot of Children’s Coverage (2017). Retrieved from: http://ccf.georgetown.edu/wp-content/uploads/2017/02/DCMedicaidCHIP.pdf

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