Washington, D.C. has the second-lowest rate of people who lack health insurance in the country, but many residents are facing new barriers to health care due to provisions of the sweeping federal law passed in July, which threatens access for thousands. 

Changes to insurance eligibility and the rising cost of premiums, which kicked in for some in October and others more recently, are expected to leave many more patients uninsured or unable to afford medical care. Federally qualified health centers, including D.C.’s Whitman-Walker Health, where 10 to 12 percent of patients are uninsured, are bracing for an influx of newly uninsured patients while facing their own financial challenges. 

Even in D.C., where uninsured rates have been among the lowest in the country, changes brought on by the passage of the Republican mega bill (known as the “Big Beautiful Bill”) will have major effects. 

The changes from the bill affect Medicaid, which is free to low-income patients, and subsidies for insurance that people buy on the health insurance exchanges that were started under the Affordable Care Act, which were allowed to expire on Dec. 31. 

Erin Loubier, vice president for access and strategic initiatives at Whitman-Walker Health, says some Whitman-Walker Health patients have received notices about premium increases, including several who say the increases are up to 1,000 percent more than they were paying. 

“That is like paying rent,” she says. “We live in an expensive city, so any increases are going to be really, really hard on people.”

Whitman-Walker Health and other healthcare providers are expecting the changes to have multiple effects — some patients may not be able to afford coverage or may avoid going to the doctor and allow health conditions to worsen because they can’t afford care, and many more will be seeking care who don’t have insurance. 

“I’m worried that we’re going to not just have people who can’t get care, but that they delay care until they’re really sick, and then the care is not as effective because they might have waited too long, and then we may have a less healthy population,” Loubier says.

Loubier says delaying care, and serving more people without insurance has major implications for Whitman-Walker Health and other health centers serving the community.

“There’s going to be a lot of pressure on us to try to find and raise more money, and that’s going to be harder, because I think all organizations who provide health care are going to be facing this,” she says. 

The U.S. health care system is the most expensive in the world, and has much higher out-of-pocket costs for individuals. But in other countries like the United Kingdom, Australia, Canada, and many others, health care is much less expensive — or even free.

Even though the U.S. has a high-priced healthcare system, critics say there are still ways to bring down costs by forcing insurance and pharmaceutical companies to absorb more of the costs, rather than transferring the costs to patients.

“In the U.S., they end up trying to cut costs at the person’s level, not at the level of the different corporations or structures that are making a lot of money in healthcare,” said Loubier. “Our system is so complicated and there is probably waste in it, but I don’t think that that cost and waste is at the ‘people’ level. I think it’s higher up at the system level, but that is much, much harder to get people to try to make cuts at that end.”

Ultimately at Whitman-Walker Health, healthcare providers and insurance navigators are planning to help with everyday necessities when it comes to healthcare coverage and striving to provide healthcare in partnership with patients, said Loubier.

“The key here is we’re going to have a lot of people who may lose insurance, and they’re going to rely on places like Whitman-Walker Health and other community health centers, so we have to figure out how we keep providing that care,” she said. 

(This article was written by a student in the journalism program at Bard High School Early College DC. This work is part of a partnership between the Washington Blade Foundation and Youthcast Media Group, funded through the FY26 Community Development Grant from the Office of D.C. Mayor Muriel Bowser.)

D.C. Mayor Muriel Bowser on March 20 signed a bill approved by the D.C. Council that requires health insurance companies to cover the costs of HIV prevention or PrEP drugs for D.C. residents at risk for HIV infection.

Like all legislation approved by the Council and signed by the mayor, the bill, called the PrEP D.C. Amendment Act, was sent to Capitol Hill for a required 30-day congressional review period before it takes effect as D.C. law.

Gay D.C. Council member Zachary Parker (D-Ward 5) last year introduced the bill.

Insurance coverage for PrEP drugs has been provided through coverage standards included in the Affordable Care Act, known as Obamacare. But AIDS advocacy organizations have called on states and D.C. to pass their own legislation requiring insurance coverage of PrEP as a safeguard in case federal policies are weakened or removed by the Trump administration, which has already reduced federal funding for HIV/AIDS-related programs.

Like legislation passed by other states, the PrEP D.C. Amendment Act requires insurers to cover all PrEP drugs approved by the U.S. Food and Drug Administration.

Studies have shown that PrEP drugs, which can be taken as pills or by injection just twice a year, are highly effective in preventing HIV infection.

“I think this is a win for our community,” Parker said after the D.C. Council voted unanimously to approve the bill on its first vote on the measure in February. “And this is a win in the fight against HIV/AIDS.”  

Longtime Washington Blade Editor Kevin Naff will be inducted into D.C.’s Society of Professional Journalists Hall of Fame in June, the group announced this week.

Hall of Fame honorees are chosen by the Society of Professional Journalists’ Washington, D.C., Pro Chapter. Naff and two other inductees — Seth Borenstein, a Washington-based national science writer for the AP and Cheryl W. Thompson, an award-winning correspondent for National Public Radio — will be celebrated at the chapter’s Dateline Awards dinner on Tuesday, June 9, at the National Press Club. The dinner’s emcee will be Kojo Nnamdi, host of WAMU radio’s weekly “Politics Hour.”

“I am tremendously honored by this recognition,” Naff said. “I have spent a lifetime in the D.C. area learning from so many talented journalists and am humbled to be considered in their company. Thank you to SPJ and to all the LGBTQ pioneers who came before me who made this possible.”

Naff joined the Blade in 2002 after years in print and digital journalism. He worked as a financial reporter for Reuters in New York before moving to Baltimore in 1996 to launch the Baltimore Sun’s website. He spent four years at the Sun before leaving for an internet startup and later joining the mobile data group at Verizon Wireless working on the first generation of mobile apps.

He then moved to the Blade and has served as the publication’s longest-tenured editor. In 2023, Naff published his first book, “How We Won the War for LGBTQ Equality — And How Our Enemies Could Take It All Away.”

Previous Hall of Fame inductees include luminaries in journalism like Wolf Blitzer, Benjamin Bradlee, Bob Woodward, Andrea Mitchell, and Edgar Allen Poe. The Blade’s senior news reporter Lou Chibbaro Jr. was inducted in 2015.