**FILE** The D.C. Council chamber at the John A. Wilson Building in D.C. (Courtesy of dccouncil.us)
**FILE** The D.C. Council chamber at the John A. Wilson Building in D.C. (Courtesy of dccouncil.us)

After months of wrangling between the District government and managed care organizations, the D.C. Council approved, 10-3, on Oct. 18 Medicaid contracts to service the city’s indigent 250,000 patients until 2028.

The approximately $8.8 billion contract was awarded by the council to health care providers AmeriHealth Caritas, AmeriGroup and MedStar Health. CareFirst, the fourth company, lobbied the council intensely for the chance to have a piece of the contracts but fell short in the process.

Voting for the contracts were D.C. Council Chairman Phil Mendelson (D), and Council members Anita Bonds (D-At Large), Elissa Silverman (I-At Large), Trayon White (D-Ward 8), Charles Allen (D-Ward 6), Janeese Lewis George (D-Ward 4), Kenyan McDuffie (D-Ward 5), Mary Cheh (D-Ward 3), Robert White (D-At Large) and Christina Henderson (I-At Large). Opposing the awarding of the contracts were Council members Brooke Pinto (D-Ward 2) and Brianne K. Nadeau (D-Ward 1). Council member Vincent C. Gray (D-Ward 7) was not present to vote but made his feelings clear on the issue. Gray serves as the chairman of the Committee on Health.

“I am encouraging my council colleagues to vote ‘No’ on the MCO [managed care organization] declaration resolutions so that we ensure District residents are presented the best health care options through a transparent and error-free procurement process,” said Gray in a statement.

Medicaid serves as the federally-funded, locally-managed health care plan for those who count as low-income, disabled, under the age of 19, pregnant, some senior citizens and needy single parents. In the District, managed care organizations (MCO) like CareFirst serve Medicaid patients who do not pay for their medical care. Those who qualify for the program range from an individual who earns up to $19,000 annually to a family of four with a combined income of no more than $37,000 a year. District government statistics reveal 33% of the city’s population utilizes Medicaid.

Officials of the Bowser administration submitted the contracts for council approval. District law states any contract above $1 million must be approved by the council.

Gray also voiced his concerns in an Oct. 3 letter addressed to D.C. City Administrator Kevin Donahue. He expressed reservations about the city giving a contract to a company “with a well-documented record of denying care could undo much of our hard-fought progress [in assisting low-income residents].” In the letter, he didn’t identify the company.

CareFirst sought to be a part of the present Medicaid contract but had problems during the procurement. Carefirst officials complained about being penalized for clerical errors in its paperwork and would often to point out the legal problems of its competing medical providers in conversations with council members and staffers and the general public during the appeals process. Plus, CareFirst released a survey earlier this year of 800 registered District voters between July 23-31 conducted by GQR Research, based in Northwest. The survey revealed 62% of registered voters thought CareFirst should remain in the Medicaid program even when informed that CareFirst made a minor technical error in the contracting process.

However, even though council members felt the procurement process had its flaws, they supported awarding the contracts.

“I am going to vote for it,” Trayon White said. “The contracts went through the appeals process. I will fight for equity and truth and justice for those who are on Medicaid and will see that they are treated fairly.”

Allen said he didn’t like the procurement process but said “I’m not voting against these contracts.” Lewis George voted for the contract but said what she felt the direction the District and the country needed to go in regards to health care coverage.

“I believe in Medicare for all,” she said. “This is OK for now but I look forward to the day when we in this country will have a single-payer system.”

Silverman stressed the importance of the awards, saying the contracts are the largest given out by the District government.

“People’s health care is at stake,” she said. “The procurement process has been messed up from the beginning.”

Mendelson said Medicaid contracts will involve some level of controversy no matter who wins and who loses. He said the council should remain a part of the procurement process.

“I support the council’s authority to approve contracts,” he said. “We have found that when the council doesn’t have that authority, the procurements are not good.”

Robert White handled the contracts as the chairman of the Committee on Government Operations and Facilities. He said contracts should be based on the best interest of District residents, not the desires of a single company.

“CareFirst doesn’t like the result,” he said. “All of the companies have had legal issues. You can Google search the lawsuits against all of them.”

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James Wright Jr.

James Wright Jr. is the D.C. political reporter for the Washington Informer Newspaper. He has worked for the Washington AFRO-American Newspaper as a reporter, city editor and freelance writer and The Washington...

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