Medicaid
Public health insurance for low-income people, jointly funded by the federal and state governments. It covers doctor visits, hospital care, prescriptions, pregnancy, and children's care. States run it under federal rules, and each state has its own name and details (California calls it Medi-Cal).
Key difference in this state
Here is the thing that runs against what most people expect, and it goes first: in the District of Columbia, not qualifying for Medicaid is itself the thing another programme is for. DHCF defines the Health Care Alliance, word for word, as a "locally-funded program designed to provide medical assistance to District residents who are not eligible for Medicaid." Most people assume that not qualifying for Medicaid means paying out of pocket; the District built a programme, out of local tax money, specifically for those people. On DHCF's Alliance page we did not find anything about immigration status. The conditions that page lists are three: be a District resident, meet the financial eligibility requirements, and "not have any other health or medical health coverage." We are not writing a status rule on the agency's behalf, and we do not restate the federal rules here, because a restatement is a second version and a second version drifts from the source. Ask DHCF about your own situation on (202) 442-5988. ( So you know we looked: DC Health Link has a page specifically on coverage options for residents who are not eligible for most programmes because of immigration status. That page returns 403 to us and we cannot open it — that is a limit on our retrieval, not evidence the page is wrong. It is worth your own look.) Three changes took effect on October 1, 2025 — not "coming", already in force: (1) The merger. The agency's words: "Effective October 1, 2025, The Health Care Alliance and [Immigrant Children's] Program (ICP) will merge into one program", now called the DC Health Care Alliance. (2) No new enrollments at 26 or older. The agency's words: "Starting October 1, 2025, the Health Care Alliance program will no longer enroll new applicants … aged 26 or older into the program." But "new applicant" is defined by the agency, and this is the part that matters most — do not let the sentence above frighten you off. In that same sentence the agency writes that new applicants are "those not currently enrolled in the program or in a renewal period", and it adds: "A new applicant is someone who is not currently receiving Health Care Alliance but would like to apply for the program." So if you are already enrolled, or you are in a renewal period, you are not a "new applicant" — this rule is not pushing you out. (3) The income limit for people aged 21 and over falls from 215% FPL to 138% FPL. Three things are not changing, listed by the agency under "What's Not Changing": no income limit changes for children aged 0-20; no face-to-face requirements; certification spans remain every 12 months. It is worth being clear about when (3) actually lands on you: a lower income line does not remove people the same day. It reaches you on the day of your 12-month recertification. So "I still have coverage right now" does not mean this is not about you. If you are 21 or older and your household income is between 138% and 215% FPL, ask DHCF now what happens at your next recertification and what else is open to you — rather than waiting for a termination notice to ask. One easy and useful thing: DHCF publishes the Alliance handbook in Chinese, Spanish, Amharic, Korean and Vietnamese. Get one in a language you read, instead of relying on someone else's summary. Practical note: if the people in your household are in different situations, it is worth consulting a licensed immigration attorney or a DOJ-accredited representative before you submit — many offer free or low-cost help. Public charge: the federal conclusion — including what changes from September 18, 2026, the statutory exemptions, and how it differs abroad and at a port of entry — is set out in the program-level section on this page and is not repeated here; repeating it would create a second source of truth. For your own case, consult a licensed immigration attorney.
Source:DC Department of Health Care Finance (DHCF) · checked 2026-08-07
- View the official document: "DC Health Care Alliance for Adults (‘Alliance’)" — DC Department of Health Care Finance (DHCF). Definition: "DC Health Care Alliance for Adults (‘Alliance’) Program is a locally-funded program designed to provide medical assistance to District residents who are not eligible for Medicaid." Income: "Have income at or below 138% of the federal poverty level (‘FPL’)" with the composition noted as "133% + 5% disregard"; published monthly limits run from $1,836 (1 person) to $6,408 (household of 8). Conditions: "To be eligible for Health Care Alliance, you must be a resident of the District of Columbia, meet financial eligibility requirements, and not have any other health or medical health coverage." Agency contact: 441 4th Street NW, 900S, Washington DC 20001; phone (202) 442-5988; TTY 711; office hours Monday to Friday 8:15 am to 4:45 pm. 🔴 Negative evidence: this page states nothing about immigration status, does not say where to apply, and does not list required documents. (Opens in a new tab)
- View the official document: "Health Care Alliance Program Changes 2026" — DHCF (page title carries the programme year; the changes it describes are "Health Care Alliance Changes Effective October 1, 2025"). Verbatim from the page: "Name Change: Alliance and Immigrant Children's Program (ICP) becomes one program called DC Health Care Alliance." "No new enrollments in the Alliance program for individuals 26 and older." "DC Health Care Alliance income limit for individuals 21 years of age or older decreases from 215% to 138% of the federal poverty limit (FPL)." Under "What's Not Changing in Health Care Alliance": "No income limit changes for children (0-20). No face-to-face requirements. Certification spans remain every 12 months." 🌟 From DHCF's companion FAQ PDF (dated August 2025, "Health Care Alliance Frequently Asked Questions"): "New! Effective October 1, 2025, The Health Care Alliance and [Immigrant Children's] Program (ICP) will merge into one program called the Health Care Alliance Program for Adults and Children." and "Starting October 1, 2025, the Health Care Alliance program will no longer enroll new applicants (those not currently enrolled in the program or in a renewal period) aged 26 or older into the program. A new applicant is someone who is not currently receiving Health Care Alliance but would like to apply for the program." The page also links the Alliance Health Care Handbook 2026 in English, Spanish and Amharic, and "Benefit Changes - for Enrolled Alliance Members" in English, Amharic, Spanish, Korean, Chinese and Vietnamese; and announces beneficiary/stakeholder meetings every other Wednesday. (Opens in a new tab)
- View the official document: "Medicaid Income Limits" — DC Department of Health Care Finance (DHCF). Verbatim: "Medicaid income limits for Parent/Caretaker Relatives and Childless Adults decreases to 138% of the federal poverty limit (FPL). See samples of income changes below." Table — Current Childless Adult (Ending 12/31/2025): 210% + 5% disregard; 1 person monthly $2,806; 2-person $3,790; 3-person $4,775; 4-person $5,762. Current Parent or Caretaker (Ending 12/31/2025): 216% + 5% disregard; $2,884 / $3,896 / $4,908 / $5,923. New Childless Adult and Parent/Caretaker (Effective 1/1/2026): 133% + 5% disregard; $1,800 / $2,432 / $3,065 / $3,697. 🔴 Verbatim: "Parent/Caretaker Relatives and Childless Adults whose income exceeds 138% of the federal poverty limit will lose Medicaid on 12/31/2025." 🔴 Negative evidence: this page carries no household sizes above four, and says nothing about how affected people were notified or what alternatives they were offered. (Opens in a new tab)