Cedar Hill may not be enough for Southeast D.C.'s underserved communities

WASHINGTON—Residents of Southeast D.C. have felt medically neglected for decades. 

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Despite calls for improved healthcare access and a brand-new hospital on the horizon, many question whether the new facility will truly meet the community’s critical needs. Experts say Medicaid and overall hospital funding may be one reason for the area’s ongoing lack of quality healthcare.

 

D.C. Wards 7 and 8 have been designated as medically underserved areas since 2007 by the Health Resources and Services Administration — a federal agency that focuses on improving access to healthcare services. Advisory Neighborhood Commissioner and Ward 8 resident Robbie Woodland explained that improved local healthcare is the bare minimum of what her community needs. Many of her neighbors and fellow residents share her sentiment, Woodland added.

 

“They’re looking for better healthcare over here. They’re looking for accessibility,” Woodland said.

 

Since 1966, the only hospital in Wards 7 and 8 has been United Medical Center (UMC). Long-time residents attest that UMC has not met the community’s medical needs in decades and has been financially unstable for years. By 2018 the hospital was described as “functionally bankrupt”.

 

Woodland has seen the degradation with her own eyes.

 

“UMC? That hospital has been declining since I was a little girl,” she said. “I’m 51.”

 

Along with financial difficulties, UMC was also not equipped to treat victims of gun violence in the area, Woodland said. 

 

In 2023, roughly two-thirds of D.C. homicides occurred in Wards 7 and 8 — with nearly twice as many homicides occurring in Ward 8 than in any other ward, according to The Washington Post. 

 

Gunshot victims in these wards were often transported to hospitals farther away to receive necessary care, creating potentially life-threatening delays. 

 

A hospital located in Southeast D.C. must be able to directly treat victims of gun violence, Woodland said.

 

“The hospital that we had couldn’t meet the demands of the community with all of the violence here,” she said. “We’re more of the dumping grounds. We get everything that no one wants in the other wards.”

 

Systemic challenges, like a reliance on Medicaid, exacerbate the lack of quality care in medically underserved populations like Southeast D.C. Medicaid pays far less for treatments than private insurance companies, resulting in tighter budgets for hospitals in communities that are more reliant on federal aid, Matthew Fiedler, a senior fellow at the Brookings Institution, said. This limits investment in advanced therapies or services, unlike hospitals located in higher-income neighborhoods, Fiedler explained.

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“The key barriers are financial,” Fiedler said. “Policy influences that by determining who’s eligible for [Medicaid] coverage and how generous that coverage is.”

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Private insurers often pay double to triple what programs like Medicare and Medicaid offer hospitals, Fiedler said. Patients also overwhelmingly choose to receive care at the hospital nearest them, he added.

 

“These are huge differences in the amount of revenue that a hospital has coming in the door,” Fiedler said.

 

Roughly 45 percent of Washington D.C. residents are covered by Medicaid. 

 

Although Washington has one of the most generous Medicaid programs, there are still those who fall through the cracks and are in need of emergency medical care but lack insurance, Jack Hoadley, a research professor emeritus at Georgetown University’s Health Policy Institute said. Hospitals are often left to pick up the pieces, he added.

 

“They struggle to take care of everybody,” Hoadley said. “It’s a struggle for a hospital to cover those costs through other means.”