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.