Research by Author & Topic

Publications by Randall R. Bovbjerg on Washington D.C. Region

The uninsurance rate in the District is lower than the national average, but an unacceptably high number of residents remain uncovered. To help assess ways to improve coverage, the DC Department of Health convened the Health Care Coverage Advisory Panel under the District's State Planning Grant (SPG). This final report of the Panel, staffed by the authors, makes eight recommendations, including better outreach and enrollment in Medicaid and other existing public programs, allowing uninsured residents to buy in to such programs, better information on private options, and ongoing monitoring of coverage accomplishments and prevailing insurance market conditions.

This testimony described DC populations lacking health coverage and issues that expansion proposals need to address. The biggest gaps in coverage lie within the District's generous Medicaid and Alliance programs. All residents with family incomes up to 200% of the Federal Poverty Level are eligible but many are not enrolled. Another, smaller group of uninsureds have incomes of 200-400% of FPL, but subsidizing them to buy coverage requires addressing potential crowd out among 80,000 similar-income already insured residents. Expansion also needs to address the potential for adverse selection as costs for the uninsured range widely by age and health status.

[Washington Post] After months of wrangling, a decision has been made: D.C. General Hospital will close. Its replacement, a private health care network of local clinics and hospitals led by Greater Southeast Hospital, promises to improve care while containing costs.

Urban Institute researchers, Randall Bovbjerg and Barbara Ormond, testify before the DC City Council, Committee on Human Services on the changing hospital sector in Washington, D.C. and what implications such changes have for the poor.

The Washington, D.C. hospital sector has an excess of hospital beds and a concentration of services at the high end. Four community hospitals; three academic medical centers; a large, nonacademic tertiary care hospital; five specialty hospitals; and a public general hospital all compete to serve a city with a population of only 500,000. In addition, there are two military facilities. Forty percent of patients in this market are drawn from the adjacent Maryland and Virginia suburbs. The market is poised for change, driven by insurance market trends.