CommunityHealth

D.C. Residents May Lose Some Access to Medicaid through MedStar After Sept. 30

Expiring Contract Casts Broad Shadow Over Health Care Delivery

D.C. residents may lose access to MedStar Health System, a health care network that delivers treatment under Medicaid to local residents.

In a letter written to Attorney General Karl Racine, Council member At-Large Elissa Silverman and Council member Kenyan McDuffie wrote their concerns of MedStars’s plans to discontinue services to Medicaid insurers and said, “It is unfair for a health system to use the resources of its tax-exempt charitable entities for the benefit of its taxable business affiliates in a manner that defeats the charitable purpose.”

The two are also concerned that MedStar is unfairly influencing Medicaid contracting in the city and is “designed to force the city to take actions that would benefit MedStar.”

The D.C. Healthcare Alliance is a medical assistance program that is locally funded in D.C. for those who do not qualify for Medicaid and for residents of low-income communities who are not covered by any other medical insurance. Eligibility is spelled out on the District’s web site at the page for the D.C. Department of Health Care Alliance.

“MedStar is a valuable partner in our city’s health care system. We have learned from past experiences that when access to one major acute care hospital is reduced, the impact will echo through the city’s entire health care system,” Mayor Muriel Bowser said.

“As a result, all residents – not just the publicly insured – will face unacceptable waiting periods in crowded hospital emergency rooms, difficulty securing primary care visits, and lengthy 3- or 4-month delays for specialty care appointments,”

The contract for MedStar is set to expire Sept. 30, 2021 which will leave D.C. residents without access to the health care system. Over 250,000 people in the city rely on Medicaid and such programs for health care. The end of the MedStar contract threatens that.

“I am aware that many of the 250,000 District residents who receive their health care through the District’s managed care program now face a loss of access to the critical services offered by the MedStar Health System,” Bowser said.

“When the council, by a 7-6 margin, refused to support a reasonable exemption that would have allowed MedStar’s managed care organization to complete the procurement process, circumstances were created that now threaten the very access to treatment for managed care enrollees at all MedStar hospitals, clinics, their specialty care physicians, and its rehabilitation hospital,” the mayor added.

In a statement issued late last month, the mayor said she would announce her proposal to protect the residents of the city and “will keep fighting for these residents to prevent a chaotic and abrupt disruption.”

On Sept. 1, the mayor issued an emergency order warning that because MedStar provides a significant portion to the Medicaid and Alliance program “negative impacts that will result from this lack of access to MedStar system is particularly high.”

The order was set to be effective immediately and will last for 15 days.

Council member Robert White along with Councilmember Kenyan Mcduffie, Councilmember Elissa Silverman and Chairman Phil Mendelson proposed a disapproval resolution of the contract with MedStar Family Choice.

White tweeted: “MedStar announced that if it does not win a managed care contract, it will no longer allow Medicaid patients to use its doctors or facilities. Now days before these contracts expire, the Mayor has declared an emergency as a way to extend the contracts.”

He tweeted further: “This disapproval resolution gives the Mayor the time to comply with the law and minimize disruption while the council decides on its next steps.”

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