Committee on Health Hearing on FY27 Budget for DC Health Benefit Exchange Authority – May 6, 2026
Committee on Health Hearing on FY27 Budget for DC Health Benefit Exchange Authority – May 6, 2026
At-large Councilmember Christina Henderson, Chair of the Committee on Health, convened a hybrid hearing on Wednesday, May 6, 2026, at 9:31 AM in Room 123 of the John A. Wilson Building to review the proposed FY27 budget for the DC Health Benefit Exchange Authority (HBX). The hearing featured testimony from public witnesses and a government witness, HBX Executive Director Mila Kaufman, who discussed the Healthy DC Plan, Health Care for Child Care, federal policy impacts, and the agency's budget request.
Public Comments & Testimony
- Jacob Spidel (LegalAid DC) strongly supported the $5.7 million proposed for dental and vision benefits for Healthy DC enrollees, calling the loss of those benefits “devastating.” He urged raising the Healthy DC income limit from 200% of FPL to the former Medicaid limits (215% FPL for childless adults, 221% for parents) and called for continuous enrollment beyond the first year to avoid gaps.
- Ann Gunderson (DC FPI, Under 3 DC coalition) urged preserving the mayor’s $12 million annual investment in Health Care for Child Care and the $5.7 million for dental/vision benefits. She noted that over 3,500 child care employees and families have benefited, and that the program has become a national model.
- Raúl Echavaria (Communikids Preschool) described child care as essential infrastructure and warned that weakening the pay equity fund and Health Care for Child Care would lead to classroom closures, higher costs for families, and reduced workforce participation.
- Patricia Quinn (DC Primary Care Association) supported dental/vision benefits and urged the Council to identify resources to cover lawfully present immigrants who will lose coverage under HR1 changes, affecting approximately 400 HBX enrollees.
- Neil Christie (Ward 1 resident) praised DC Health Link’s customer service and argued that health care is a human right and government’s responsibility.
- Nigel Warren (Ward 6 parent) shared his family’s experience with job loss and the importance of DC Health Link and Medicaid in providing stable, affordable coverage.
- Chiniati Hubbard (DC Chamber of Commerce) supported the HBX budget as proposed, noting the chamber’s extensive outreach to small businesses (over 100,000 emails, 600 calls, 750 in-person connections, 200 referrals). She emphasized the value of DC Health Link for small employers.
- Axel Martin Del Campo (Ward 4 resident, rare disease patient) insisted on protecting and expanding DC Health Link, stating that even a brief coverage gap can be “life and death.”
- Veronica Hernandez (Mary Center) reported that in FY25 Mary Center assisted 3,801 residents, with 2,290 enrolled in coverage. She noted confusion from auto-enrollment into the Basic Health Plan and urged stable funding.
- Gustavo Wally (Ward 4 resident, kidney transplant recipient) shared that without ACA coverage through DC Health Link he would not be alive. He stressed that continuous access to immunosuppressive medications is essential.
- Marcelo Barros (Ward 2, small business owner) described DC Health Link as “incredible” and said the Healthy DC Plan has allowed him to maintain health coverage despite fluctuating income.
- Elham (founder/director, WeWorld Early Childhood Enrichment Hub) testified that Health Care for Child Care allowed her center to offer health insurance, which has been critical for attracting and retaining staff.
- Maria Gomez (Mary Center, BHP Advisory Council) urged full funding for HBX, noting that 15,000 individuals have transitioned from Medicaid to the Basic Health Plan, and the exchange has worked to cover lawfully present residents not eligible for federal funding.
- Lee Bethel (insurance consultant/broker) asked the Council to fully fund the SHOP marketplace and continue Health Care for Child Care, which enables small employers to offer coverage.
- Christopher Gardner (Chair, Standing Advisory Board) described the board’s work on special enrollment periods and urged adequate funding for HBX to maintain operations and outreach.
- Donna Stevenson (Community of Hope) reported a $200,000 drop in dental revenue since the transition to Healthy DC and supported increased FTEs for the Healthy DC plan.
- Che Riddle Tavasola (Restaurant Association of Metropolitan Washington) described HBX as “vital” for restaurants facing closures; RMW engaged over 600 owners/operators through events and digital outreach.
- Martha Herndon (child care center director) said Health Care for Child Care cut staff turnover from as high as 75% to nearly zero, and allowed her to offer health insurance after her husband lost his job.
Discussion Items
- Chair Henderson opened by commending HBX for quickly establishing the Healthy DC Plan and for excellent customer service. She noted the cruelty of federal policies that strip coverage from lawfully present immigrants and expressed concern about the upcoming Medicaid work requirements.
- Director Mila Kaufman presented an update: Healthy DC enrollment is 14,826; a fourth auto-enrollment round was completed; work with CareFirst to cover 44 lawfully present residents below 100% FPL; dental/vision benefits are planned for January 1, 2027, if funded; and there are 2,357 enrollees at risk due to outstanding verifications. She also flagged that a proposed CMS rule on state-required benefit mandates could cost DC at least $8 million, and that HR1 changes (disallowing auto-renewal) may require multi-million-dollar system re-architecture.
- Chair Henderson and Director Kaufman discussed premium drivers (loss of federal subsidies, medical cost increases), the anonymous shopping tool, the Octo contract ($63,000 increase), the Health Care for Child Care waitlist (one facility), the IVF benefit (971 users in 2025), HIV prevention cost-sharing implementation, and the outstanding verification outreach strategy.
- Director Kaufman confirmed that continuous enrollment after the first year is not permitted under current federal approval, and that HBX will seek to work with carriers on enrollee notification.
Key Outcomes
- No votes were taken; the hearing was for testimony and budget review.
- Chair Henderson directed HBX to provide a blurb for Council members to help reach enrollees with outstanding verifications.
- The committee will consider the mayor’s proposed $5.7 million for dental/vision, $12 million for Health Care for Child Care, and the overall HBX budget (proposed at $57.5 million, a 3.85% increase over FY26).
- Director Kaufman committed to evidence-based decisions on extending continuous enrollment, and noted that implementation of dental/vision benefits will begin January 1, 2027, if funding is maintained.
- The committee will continue to monitor federal HR1 impacts and the potential cost of state benefit defrayal.
Meeting Transcript
All right, good morning. I'm at large councilmember Christina Henderson, Chair of the Committee on Health. Today is Wednesday, May 6, 2026. The time is 9 31 a.m. We are in room 123 of the John A. Wilson building. This is a hybrid hearing with uh government witnesses testifying in person, and we'll hear from public witnesses on both in person and online. This hearing is being broadcast live on Cable Channel 13 as well as on my YouTube page at CMC Henderson. I'm calling to order this meeting of the committee on health for the proposed FY27 budget for the health benefit exchange. We'll hear testimony from both again today. Let me tell you a little bit about health benefit exchange. So DC Health Benefit Exchange Authority or HBX is a quasi-governmental agency of the District of Columbia government charged with implementing and operating the district's health benefit exchange. The exchange operates DC HealthLink, an online insurance marketplace for district residents and small businesses. DC HealthLink fosters competition and transparency in private health insurance market, enabling individual small businesses to compare health insurance prices and benefits and to purchase affordable quality health insurance. The health benefit exchange has expanded their scope of services available in the last year by developing the basic health plan, also known as the Healthy DC Plan, which is a coverage option for individuals between one hundred and thirty-eight and two hundred percent of the FPL who lost Medicaid coverage this past year. HBX works closely with the Department of Healthcare Finance to make this transition as smooth as possible. And I want to commend Director Kaufman and her team for their quick and effective work. If you're here in person, there are timers here. If you're virtual, if you go to gallery view, you'll be able to see the timer there in the box. Patricia Quinn. Okay, Jacob, when you're ready. Thank you to the chair for the opportunity to testify today. My name is Jacob Spidel, and I'm a staff attorney at LegalAid DC. First off, we strongly support the proposal to add dental and vision benefits for basic health plan enrollees. And we urge the council to approve the five point seven million dollars the mayor proposed to support basic health plan dental and vision benefits. The loss of dental coverage and vision coverage have been devastating for those who are transitioned from Medicaid to Healthy DC, which currently does not cover dental care except in mental medical emergencies. The cost for restoring dental and vision coverage to the healthy DC population is a fraction of the district's annual budget, but will have an outsized positive impact on those individuals who have been moved from Medicaid to Health E DC. Next up, we urge the council to increase the income limit for healthy DC from 200% of FPL up to what was the Medicaid limit. 215% of FPL for childless adults and 221% of FPL for parents or caretaker relatives. When healthy DC was created, the lower income limit meant that about over 1,500 people previously enrolled in Medicaid did not qualify for healthy DC, even though their income had qualified them for Medicaid. More broadly, the council should ensure that everyone losing Medicaid coverage due to cuts in that program can qualify for healthy DC if at all possible. Similarly, the district should support healthy DC enrollment for DC residents who lose their affordable health coverage due to changes in federal law and do not qualify for alternative coverage. Healthy DC has become an essential last resort to DC residents whose affordable health insurance is stripped away through cuts to Medicare, Medicaid, and the health care exchange. Under the one big beautiful bill act, many DC residents will lose their Medicaid coverage on October 1st, 2026. More will lose coverage January 4th, 2027, and others will lose access to affordable plans under the Affordable Care Act in January 2027. When DC residents lose access to health insurance due to these changes, DC should have funding allocated to allow them to enroll in healthy DC to the greatest extent allowed by federal law. Last, we encourage healthy DC to use continuous enrollment beyond the first year. Healthy DC is using continuous enrollment for the first year, allowing people to enroll as soon as they're eligible. After the first year, however, Healthy DC plans to switch to an open and special enrollment process that will force people to wait for certain enrollment periods, even if they're eligible. This has higher administrative costs and is a difference from Medicaid, which has continuous enrollments. Thank you for the opportunity to testify. Thank you. Anne? Chair President Henderson, thank you for the opportunity to testify. My name is Ann Gunderson, and I'm a senior policy analyst at DC FPI and member of the Under 3 DC coalition. My verbal testimony focuses on the importance of preserving the investment in health care for child care. And my written testimony provides feedback on the new healthy DC plan. These programs ensure that district residents and workers maintain access to low-cost health care so they can thrive and meaningfully contribute to the district's economy. To continue supporting health care in DC, lawmakers should maintain the mayor's proposed investment of 12 million dollars annually in health care for child care and maintain her proposed investment of 5.7 million dollars annually for restoring dental and vision benefits to healthy DC. To date, more than 3,500 child care employees and their families have benefited from health care for child care, many of whom are receiving employment-based health care for the first time.
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