“And I felt shame when my daughter got older, and I had to keep taking her out of school to stand in that line,” Salado, 28, said. “Sometimes, it was still dark when we’d get in line.”
This was what it took to be eligible for health care with the DC Healthcare Alliance, an otherwise terrific city-funded health insurance system in the District for those who aren’t eligible for Medicaid or don’t have private insurance.
Often, a whole day of waiting still didn’t mean they’d get seen. Going to the bathroom, having the wrong part of a lease agreement, showing a pay stub that’s too old by a matter of days meant they could lose the spot in line and have to start over again on another day.
Most often, it’s the working immigrants who help the city run — who pay taxes, but can’t get services — who get health insurance this way.
But families have to requalify every six months, unlike the usual yearly renewal of other assistance programs. That change was made shortly after the program was created two decades ago, allegedly to prevent fraud.
Research showed there was little fraud. But there was an instant drop in enrollments as soon as the six-month renewal program began, Kate Coventry, senior analyst at the D.C. Fiscal Policy Institute, said in council testimony in October.
And the effects of that onerous process — demanding in-person interviews and recertification — was instantly apparent on the lives of local immigrants who relied on the insurance.
“The ones trying to get a high school diploma, they miss so much school because of this,” said Billy Cerullo, student services coordinator at Briya Public Charter School, where he helps adult students pick which school days they can afford to miss so they can get insurance for their families. Because, too often, he sees that rolling the dice on health coverage is easier than losing work and school days to keep renewing.
“It’s almost like they have this great program,” Salado said, “but they really don’t want us to use it.”
Then, suddenly, as soon as everything closed for the pandemic, the whole burdensome registration process was suspended.
No standing in lines around the block for hours. No taking off days of work or school needed.
“Now, they told us it’s automatically renewed,” Salado said. And that’s how it should be.
All it took was a global pandemic.
Advocates and legislators have been fighting for years to change the ridiculous renewal process for the DC Healthcare Alliance.
“We work, we all pay taxes,” Salado said. “But to make it even harder for us to get health care, it makes us feel less than human.”
There is an archive of D.C. Council testimony talking about the preposterous system. Year after year, legislation is proposed or discussed to change the burdensome renewal process that cuts the reach that the program has had in its two decades. But then it’s tabled or held over or forgotten.
In March, days before the region went into a coronavirus shutdown, a group of women testified before D.C. Council member Vincent C. Gray (D-Ward 7) about the days they miss from work and their children miss from school as they would get on a bus at 4 a.m. or wait in the car at 6 a.m. to stand in line for the recertification process.
Salado — who is still fighting with her health provider to prove the renewal is valid — was one of the women who spoke to Gray last year. He listened patiently, yet again.
“We’ve heard the stories, too, about people coming at 3 o’clock in the morning, 4 o’clock,” Gray said. “We think it needs to be changed. . . . For those who have had to stand in line, for these very long periods, I’m sorry for that.”
In a November hearing, Gray again apologized for the process and said “making two simple changes to the DC Healthcare Alliance program has been a long-standing source of frustration.” They didn’t have funding to change the recertification process — an easier process means that more people will be insured.
And that’s a good thing, especially during a national health emergency, council member Brianne K. Nadeau (D-Ward 1) said in the same hearing.
“Because of the risk of covid, they have been able to enroll in Alliance and not recertify every six months,” Nadeau said. “While we continue to social distance, this remains an essential service. When it ends, we should move forward with innovations we’ve created and not the inefficiencies pre-covid.”
At last, in January, a bill streamlining the eligibility process was approved by all the council members but was returned unsigned by D.C. Mayor Muriel E. Bowser (D) after she expressed concerns about the higher cost of the program.
More than 15,000 families who use the program are waiting to hear whether their health-care access will be made easier.
It’s time for this years-long battle to end.
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