District of Columbia FQHC Intelligence

DHCF's August 26 eligibility briefing says that immigration-status changes take effect October 1, 2026: some people with legal immigration statuses will lose Medicaid eligibility, while some may transition to Alliance, Basic Health Plan, or assisted qualified health-plan coverage. The briefing says lawfully residing children under 21 and pregnant people, emergency Medicaid, and people already enrolled in Alliance are not affected by this provision as described.

DHCF had sent requests for updated immigration information and scheduled Medicaid termination notices for August 31 and notices of new coverage options for September 15. Those notices are not themselves proof of disenrollment, and the briefing does not say every recipient will lose coverage.

Separately, work or activity rules and six-month recertification for some adults begin January 1, 2027; DHCF says outreach about the work rules must begin by September 2026.

On July 28, the Office of the Attorney General for the District of Columbia announced an agreement giving it until at least September 30 to review the proposed transfer of certain assets, physicians, and other health-care personnel from Medical Faculty Associates to Foggy Bottom Physician Group. The source says the transaction will operationally close July 31 while OAG retains the ability to modify or reject it, and describes MFA as the District's largest medical group, which has employed more than 700 providers.

This is a regulatory and continuity review, not final approval or evidence of FQHC involvement, retained jobs, clinical capacity, patient-access changes, or outcomes; September 30 is OAG's review horizon, not presented as a public deadline.

Legal Aid DC's July 13 post-final-vote account says the Council restored DC Health Care Alliance services to pre-October 2025 levels, including specialty care; funded dental and vision benefits for Alliance and Healthy DC members; restored affordable coverage for some low-income lawfully present immigrants affected by federal changes; and partially funded a Medicaid buy-in for certain workers with disabilities.

The same source says the Alliance eligibility age limit was delayed—not repealed—and that the lower Alliance and Medicaid income limits remain. Much of the FY2027 restoration uses one-time funding, so it is a time-limited operating bridge rather than a permanent reversal.

DHCF Transmittal 26-19 says DC Medicaid managed-care members enrolled with Wellpoint DC will be automatically assigned to AmeriHealth Caritas DC effective August 1, 2026. Members may choose MedStar Family Choice through January 31, 2027.

Wellpoint remains responsible for covered services through July 31, including inpatient stays that continue past termination. From August 1 through October 31, active prior authorizations, referrals, ongoing treatment, and prescriptions receive transition protections.

Providers should verify each patient's current plan and complete AmeriHealth or MedStar contracting and credentialing where needed.

Unity's patient transition page announced that care was scheduled to begin June 8, 2026 at two locations: Varnum Street, with services in Suites 312 and 317, and Unity at Perry School Health Center. Patient records were scheduled to become accessible at Unity on or after June 8 for continuity of care; the page does not independently confirm that the transition occurred as planned.

The February announcement separately says Ascension provided a $7 million charitable contribution and community-benefit grant for integration and projected that Unity would serve more than 90,000 District residents after the transition. That figure is projected organization-wide reach, not a transferred-patient count, and the sources do not establish a count of two practices.

On May 20, the Council's Committee on Health unanimously approved FY2027 recommendations that included $800,000 in one-time funds for grants to FQHCs caring for uninsured patients. The same package recommended $3.97 million for Alliance adult dental and vision benefits, $5.733 million for Healthy DC dental and vision, $907,323 to restore Alliance adult medical services to FY2025 levels, and continued Alliance eligibility at 138% FPL.

This source records the committee-stage allocations; the later final-vote outcome is reported separately rather than being retroactively attributed to the committee release.

Reporting published March 26 found that about 17,000 DC residents lost Medicaid on January 1 after the adult income-limit reduction. Roughly 15,000 were automatically enrolled in Healthy DC, while about 2,200 did not qualify for that program; only about 300 of the latter group had been reached by late March.

The same report said Alliance enrollment fell from 27,600 to about 19,000 after October 2025 changes, a decline of roughly 8,600. Healthy DC initially omitted dental, vision, and non-emergency transportation, so transfer from Medicaid was not benefit parity even when medical coverage continued.

In January 2026 oversight testimony, DHCF reported about 271,000 total Medicaid enrollees as of November 2025 and estimated that 78,000 childless adults at 0%–138% FPL would be subject to the federal community-engagement requirement. DHCF estimated 28% might meet the standard through earnings of at least 44% FPL, leaving about 56,000 who may need qualifying work, community service, education, combined activities, or an exemption.

The rule requires 80 hours per month or a qualifying alternative and must apply to covered applications and renewals no later than January 1, 2027; the 56,000 figure is not a forecast that all will lose coverage.

DC Health Link's current Healthy DC page says the Basic Health Program began January 1, 2026 and has no monthly premium or out-of-pocket cost for covered services from participating providers, including community health centers. Standard eligibility covers DC residents ages 21–64 who are not eligible for Medicaid, employer coverage, or other coverage and have income from 138% through 200% FPL.

A special 2026 exception also covers lawfully present residents below 138% FPL who are ineligible for Medicaid because of immigration status. The no-cost statement does not erase network, eligibility, or covered-service rules, and the initial benefit set did not include every Medicaid service.

DHCF Medicaid Director Letter 25-02 lowered the effective income limit for parent and caretaker-relative and childless-adult Medicaid categories to 138% FPL on January 1, 2026. The letter's table distinguishes the statutory 133% threshold plus the 5% income disregard from the effective 138% limit: childless adults moved from 210% plus the disregard, and parents or caretaker relatives from 216% plus the disregard.

People above the new Medicaid limit may be assessed for Healthy DC or Marketplace coverage, but eligibility is not automatic for every person losing Medicaid.

DHCF's official program-change page says that effective October 1, 2025 the adult Alliance income limit fell from 215% to 138% FPL, no new enrollment was allowed for adults 26 or older, Alliance and the Immigrant Children's Program were combined administratively, covered benefits changed, and delivery moved from managed care to fee-for-service.

The later measured enrollment decline and FY2027 Council outcome are documented in separate claims using their own sources rather than attributed to this October 2025 policy page.

DCPCA reported that the January 2025 federal grant-payment restriction affected DC health centers serving more than 180,000 residents, including almost 50,000 children, 16,000 older adults, and 1,000 veterans. It quantified more than $90,000 per day in inaccessible revenue while the pause continued.

The administration rescinded the original OMB memorandum after a court blocked it, although DCPCA warned that payment delays or rejections could continue under further reviews. The $90,000 figure therefore measures temporarily inaccessible cash flow during the episode, not a verified permanent daily revenue loss.

HRSA's official 2024 Uniform Data System state report lists eight reporting Health Center Program awardees in the District and 184,662 total patients. Of those patients, 100,710 (54.54%) used Medicaid or CHIP and 29,783 (16.13%) were uninsured.

DCPCA separately describes the local network as nine community health centers: eight FQHCs and one FQHC Look-Alike. The measures are not interchangeable, and the local network should not be described as nine HRSA-funded awardees.

The current DC Code defines advanced practice registered nursing as the independent performance of advanced-level nursing actions. It expressly includes advanced assessment, medical diagnosis, prescribing, selecting and dispensing therapeutic measures, and treatment.

The code also authorizes certified nurse practitioners to provide a full range of primary, acute, and specialty services. Authority remains bounded by education, national certification, population focus, licensure, and applicable rules; the statute does not impose a physician collaboration agreement on these functions.