May 9, 2012

THE DISTRICT HAS BEEN in the forefront of national efforts to provide universal health care. Indeed, it is second only to Massachusetts in the total percentage of insured residents. But progress in this area will be threatened if cuts are made to the city’s program of health benefits for low-income residents — which is why the mayor and D.C. Council need to reach an agreement to maintain funding.

With the council entering the final weeks of deliberations over next year’s budget, whether to continue to provide emergency and hospital care for the members of the city’s public health insurance program has emerged as a key issue. Mayor Vincent C. Gray (D), citing a budget shortfall, proposed cuts to the D.C. Healthcare Alliance: Members would still have coverage for primary and preventive care but not for emergency and hospital-based services.

Mr. Gray argued that the slack would be picked up by hospitals and federal programs for uncompensated care. But council member David A. Catania (I-At Large), the longtime chair of the health committee, says that critical services would be left uncovered. It’s unclear exactly how the change would be implemented.

The benefits have been in place for more than a decade, and eliminating them would tangibly affect the 19,000 people currently enrolled. For example, a cancer patient receiving chemotherapy at a hospital would no longer have that treatment covered. Many of those in the program are believed to be undocumented immigrants, and the argument has been advanced that the city need not care for those who are in the country illegally. But, as Mr. Catania rightly argues, “these individuals are here. The notion they don’t work is a lie; they work and they contribute and we shouldn’t treat them differently just because we can.”

To come up with the funds to keep the program intact, Mr. Catania made $20 million in cuts in other parts of the city’s proposed health budget. It’s unclear if the trims are realistic, but we commend his efforts to make choices and prioritize programs instead of — as is the habit of some of his colleagues — making knee-jerk proposals for new taxes. If the city believes it has $22 million to pay city employees for days not worked, as it is considering doing, it should be able to find money in a $11.28 billion budget to pay for this program. Mr. Gray’s administration has signaled a willingness to work with Mr. Catania. We urge them to find a reasonable solution.