Council of the District of Columbia

Committee on Health
1350 Pennsylvania Ave., NW, Suite 115, Washington, D.C. 20004

Good morning Mr. Mayor, colleagues, distinguished guests, ladies and gentlemen.

I want to begin by thanking Judge Ernst Liebman for being here this morning to
administer the oath of office to me. Many years ago, I had the privilege of serving as Judge
Liebman’s law clerk. It was an experience that I will always cherish. Not simply because of
the important training that I received under his guidance, but because of the example that
he set as a hard working, intelligent, and conscientious public servant. Thank you Judge.

As we prepare to swear in our new Mayor, I want to thank Mayor Fenty for his
service to our city and for the many contributions that he made to make our city better.
Mr. Mayor, I wish you and your family the very best in your future. Mayor-Elect Gray now
inherits the responsibility to lead us during these very challenging times. He is a man of
enormous integrity and considerable talent and intellect. As skilled as he is, he will not be
able to succeed without our collective assistance and support. Today, I pledge my support.
For the good of our city, I hope all of you will join me.

When we last gathered to administer oaths of office to Councilmembers in January

2009, the country was still reeling from the events of the fall of 2008 when it felt as if our
entire economy might give way. Two years later, the worst may be behind us, but
substantial challenges remain, including the urgent need to get people back to work.

Yet in spite of the challenges posed by our economy, our government has made
seemingly unimaginable progress on the issue that I care deeply about – providing quality
healthcare for every District resident!

Since 2005, I have had the privilege to chair the Council’s Committee on Health.
When I assumed this role, I set two over-arching goals. The first was to expand access to
healthcare by increasing the number of residents with insurance. The second was to
strengthen the government’s regulatory framework to improve the quality of care
delivered in the District. We have succeeded in doing both.

Six years ago, I was confronted by a government that was incapable of solving the
healthcare challenges facing its residents. For years, public officials stood by and allowed
District residents to suffer some of the worst health outcomes anywhere in the world. All
while election after election, politicians promised to do something about it, and once
elected, did nothing.

In 2005, I was determined to change this, and after 6 years of hard work – even
during these difficult times – we have been able to cut our rate of uninsured in half. In fact,
according to a 2010 Urban Institute study, the District’s rate of uninsured is just 6.2
percent – the second lowest in the nation -- and half that of both Virginia and Maryland.

We have achieved even greater progress at expanding healthcare to our city’s

children. Following an expansion initiated by the Committee on Health, our rate of
uninsured children is now just 3.2 percent – Less than a third of the national average.
Nonetheless, we must do better --- and we will. I believe that it is unacceptable for any
child in a country like ours to go without healthcare, and I will continue working hard to
ensure this does not happen in our city.

All told, there are more than 30,000 Washingtonians with publicly funded health
insurance today that were uninsured six years ago – this is approximately ½ of an entire
ward.

But our focus has not simply been to expand the number of residents, who are
insured, but to expand and improve the quality and types of services that are offered. In
this regard, I am most proud of my Committee’s work to bring comprehensive oral health
services to 60,000 adult Medicaid patients for the first time in our city’s history. Prior to
2007, the only oral health services offered to adult Medicaid patients occurred after
considerable suffering. These services took the form of tooth extractions in the emergency
room, which was both inhumane and incredibly expensive. Today, the District boasts the
most extensive preventative Medicaid dental benefits in the nation, which results in better
overall health outcomes at lower costs, and -- equally important -- affords our residents the
dignity that many of us take for granted.

In addition to our efforts to expand health insurance coverage, I am proud of the

Committee’s work over the past four years in other areas, including, among other things:
 Doubling the number of traditional public schools with full time nurses to over 95
percent of all schools,
 Investing $10 million in smoking cessation activities that led to a 24.3 percent
decline in adult smoking rates from 2005-2009. That’s 23,500 fewer adult smokers
in our city which will save us over $230 million in healthcare expenses over time,
 Substantially improving pre-school immunization rates to levels well above the
national average
 implementing the first-in-the-nation regulatory framework for pharmaceutical sales
personnel to promote safety and quality
 Developing a soon-to-be launched highly professional regulatory framework for
medical marijuana
 Dramatically improving our response to HIV/AIDS. We have undertaken massive
expansions of publicly funded HIV tests in recent years. We now test more people
than New York City or the State of Florida. We have doubled the number of
individuals on life-saving anti-retro viral drugs. And, the results speak for
themselves -- Among other things, from 2004 to 2008 – there was a 33.2% decrease
in the number of newly reported AIDS cases in the District, and a 36.1% increase in
 the percentage of people entering medical treatment within 3 months of an HIV-
positive diagnosis.

I’m also proud of organizing a $100 million investment into United Medical Center –
formerly Greater Southeast Community Hospital – which saved the only hospital east of the
Anacostia River from closing. In September of 2010, we opened a $14 million state-of-the-
art pediatric emergency department at UMC operated by Children’s National Medical
Center, which will see 20,000 children a year. Incidentally, despite reports over the
summer that the hospital would remain in the red for some time, the most recently
approved budget illustrates that the hospital will make excess of $5 million in FY 2011

Given the austerity of our times, some may be asking how we can maintain this
extensive safety net and the forward progress that we’ve made over the past few years.
The answer is the Affordable Healthcare Act championed by President Obama and passed
by Congress last Spring.

While it seems like the entire country is up in arms over the President’s initiative,
please allow me to explain how the District’s finances and future will be reshaped in a
profoundly positive way because of what our President has delivered.

First – finances. Because of the President’s healthcare initiative, the District has
been relieved of tens of millions of dollars in local expenditures that are now paid by the
federal government. For nearly ten years, the District has operated – and locally funded --
the DC Healthcare Alliance, which paid all of the costs of healthcare insurance for childless
residents below 200 percent of the federal poverty level. This program is a testament to
the generosity and compassion of the people of the District. Until recently, there were over
56,000 residents enrolled in this program. As of December 1, 2010, over 33,000 of these
individuals are now enrolled in Medicaid where the federal government pays 70 percent of
the costs.

In fact, we – along with Connecticut – were the first states to meet the 2014
Medicaid expansion requirements under the new law. And, for the record, we have
substantially exceeded the requirements set by the statute. It wasn’t that long ago when
the District led in all the wrong indicators when it came to healthcare. Now, we lead the
nation in implementing the most aggressive expansion of health care since the 1960s.

There’s another aspect of the President’s healthcare initiative that demands

attention – the potential impact on our local economy and the opportunity to train
thousands of our residents to meet the growing demand for healthcare positions made
possible by the new law. The District is the center of the healthcare industry for our
region. Eight of the District’s 16 largest private employers are hospitals. And while we
now boast the 2nd lowest uninsured rate in the nation, according to the DC Hospital
Association, each year District hospitals provide approximately $60 million in charity care
to uninsured residents of Maryland and Virginia, which negatively impacts the bottom lines
of these institutions. By 2014, when the initial health insurance requirements take effect,
these same Marylanders and Virginians will be coming to our hospitals for treatment –
except by then they’ll be able to pay. The potential impact is actually far greater for the
District’s bottom line. There are literally hundreds of thousands of suburbanites who will
soon have insurance to treat their chronic conditions. They will seek treatment in our
institutions, which means jobs and economic benefits.

The District has all of the elements needed to take advantage of the economic
benefits stemming from the President’s healthcare reform. In addition to hosting a large
number of healthcare facilities, we are home to three world class medical schools and
several nursing and allied health schools. In order to treat the millions of Americans, who
will soon have health insurance, the country needs countless new health professionals and
the capacity to train them. Why not prepare our citizens for these opportunities?

It is my hope that our new Deputy Mayor for Economic Development will work with
my Committee to develop a comprehensive plan on how the District might best take
advantage of the President’s healthcare initiative by incentivizing training in healthcare
fields and by supporting our healthcare institutions in order to prepare for the impending
influx of patients.

I want to end by thanking the citizens of the District for once again placing their
trust in me and allowing me to continue my service for another term on the Council.

Thank you for listening.