District of Columbia expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 111,319 of them (24.4% of an expansion pool of 119,001) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.
This model's bottom-up estimate is that 30,319 people in District of Columbia lose coverage by 2034: 26,979 of them still eligible but lost to paperwork and reporting failures, and 3,340 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.
Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. District of Columbia scores 76 of 100 on this model's ex parte capability index, a low band; its eligibility system is DCAS.
Key figures
| Measure | District of Columbia |
|---|---|
| Expansion state | Yes |
| Subject to the requirement via waiver | No |
| Expansion pool (adults 19 to 64) | 119,001 |
| Adults subject, strict definition | 111,319 |
| Adults subject, permissive definition | 109,092 |
| Share of expansion pool subject | 24.4% |
| Projected coverage loss by 2034 | 30,319 |
| Hardship exception status | No qualifying counties |
| Early implementer | No |
| Ex parte capability score (0 to 100) | 76 (low) |
Who is subject in District of Columbia
Of the 111,318 subject adults, 23% already work 80 or more hours a month and 71% are not working. 18% have a child under 14 at home. Among those not working, 41% report a disability and 12% are caregivers.
| Characteristic | Share of subject adults |
|---|---|
| Age 19-24 | 16% |
| Age 25-34 | 18% |
| Age 35-44 | 15% |
| Age 45-54 | 20% |
| Age 55-64 | 32% |
| Not working | 71% |
| 1 to 19 hours a month | 1% |
| 20 to 79 hours a month | 6% |
| 80 or more hours a month (meets the bar) | 23% |
| Not working: Disabled | 41% |
| Not working: Caregiver | 12% |
| Not working: Postpartum | 1% |
| Not working: Student | 5% |
| Not working: Other | 41% |
Why eligible people lose coverage
Of the 30,319 projected to lose coverage in District of Columbia, 26,979 meet the requirement or qualify for an exemption but fail to document it. 13,656 of those are working people who cannot prove their hours through data the state can see, and 13,323 qualify for an exemption the state does not detect automatically.
| Group | Projected to lose coverage |
|---|---|
| Variable shifts / on-call work | 4,027 |
| Self-employed (other) | 2,886 |
| Multiple part-time jobs (aggregation failure) | 1,846 |
| Full-time students not auto-verified | 1,382 |
| Gig / courier (DoorDash, Uber, Lyft, Instacart) | 1,260 |
| Volunteering / job training | 1,232 |
| Seasonal: agriculture, hospitality, food service | 827 |
| Cash-paid construction & trades | 196 |
| Medically frail without auto-match | 5,933 |
| Caregivers of a disabled adult | 3,820 |
| SUD treatment not flagged in claims data | 1,164 |
| American Indian / Alaska Native (tribal exemption) | 957 |
| Kinship caregivers (non-parent) of children ≤13 | 724 |
| Other categorical exemptions (foster, AYA cancer, SNAP/TANF) | 345 |
| Recent incarceration (data-match gap) | 241 |
| Parent caregivers of children ≤13 without auto-match | 109 |
| Pregnancy / postpartum data lag | 31 |
Can the state renew people automatically?
The ex parte capability index blends the state's observed automatic-renewal rate (87% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. District of Columbia's composite score is 76 (low band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.
| Component | Score |
|---|---|
| Composite | 76 |
| Observed ex parte | 87 |
| Core capability | 64 |
| Data sources | 72 |
| Historical churn | 50 |
How subjects overlap across exemption categories
| Combination | Adults | Share |
|---|---|---|
| None of the four | 64,264 | 57.7% |
| Working ≥ qualifying hours / income | 21,096 | 18.9% |
| Medically frail | 16,204 | 14.6% |
| Full-time student | 5,517 | 5.0% |
| Working ≥ qualifying hours / income + Full-time student | 2,332 | 2.1% |
| Working ≥ qualifying hours / income + Medically frail | 1,189 | 1.1% |
| Working ≥ qualifying hours / income + Parent caregiver of child ≤13 | 537 | 0.5% |
| Medically frail + Full-time student | 137 | 0.1% |
Counties in District of Columbia
Subject adults concentrate: District of Columbia (111,319) account for 100% of the state's subject population.
| County | Adults subject | Subject rate | Projected loss | Poverty rate | Working-age population |
|---|---|---|---|---|---|
| District of Columbia | 111,319 | 24.3% | 30,319 | 15.0% | 457,140 |
State brief and methodology
- District of Columbia one-page brief (PDF)
- Interactive map and state finder
- Methodology, sources, and caveats
Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.