Free Health Insurance District of Columbia: Your 2027 DC Health Link & Medicaid Guide

DC Medicaid Income Limits: Adults Now Capped at 138% FPL

The District expanded Medicaid under the ACA, and DC Medicaid is run by the Department of Health Care Finance (DHCF). For years DC covered adults well above the usual expansion line, but that ended on January 1, 2026. DHCF lowered the limit for parents and caretaker relatives from 221% to 138% of the federal poverty level, and for adults without dependent children from 215% to 138%. DHCF said about 25,000 adults would lose Medicaid eligibility that day, and that most would become eligible for the new Healthy DC Plan.

DHCF's figures use the 2026 poverty guidelines and already include the standard 5% income disregard. Over a full year, 138% FPL is about $22,025 for one person and $45,540 for a family of four; compare every state in our Medicaid income limits guide. Medicaid uses the current year's guidelines, so the dollar amounts will change once the 2027 guidelines take effect. You can apply any time of year; Medicaid has no open enrollment window.

Pregnancy and other DC programs. DHCF covers pregnant individuals through Medicaid with 12 months of postpartum coverage, and through "CHIP From Conception to End of Pregnancy" (2 months postpartum) for those who aren't eligible for Medicaid. The locally funded DC Health Care Alliance, for residents who don't qualify for Medicaid, merged with the Immigrant Children's Program on October 1, 2025. Its income limit fell from 215% to 138% FPL, and it stopped enrolling new applicants aged 26 or older; children 0–20, adults 21 to 25 and pregnant women can still apply.

What changes for DC Medicaid in 2027

DHCF's "Federal Changes to Medicaid" page lists these dates. Starting January 1, 2027, most adults ages 19 to 64 who do not have dependent children must do at least 80 hours each month of work, training, volunteering or similar activities to keep Medicaid; DHCF says more information on the work requirement is coming. The same group must renew every six months instead of once a year. Retroactive coverage also shrinks on January 1, 2027, to one month before the application for adults without children and up to two months for everyone else.

For immigrant households, adult eligibility narrowed on October 1, 2026. Lawful permanent residents (subject to a five-year bar, with exceptions), Cuban and Haitian entrants and COFA migrants keep full federally funded Medicaid as adults 21 and older. DHCF says children under 21 and pregnant individuals who are lawfully residing in the U.S. remain eligible for Medicaid.

How to apply for DC Medicaid

Apply online through District Direct (districtdirect.dc.gov, also available as a mobile app), call the Public Benefits Call Center at (202) 727-5355 (TTY 711) from 7:30 a.m. to 4:45 p.m., or visit a DC Service Center (Anacostia, Congress Heights, Fort Davis, H Street or Taylor Street).

DC Health Link Open Enrollment 2027: Dates, Tax Credits and Rates

DC Health Link is the District's ACA marketplace, run by the DC Health Benefit Exchange Authority (HBX). CMS lists DC as a state-based marketplace for plan year 2027, so DC residents don't use HealthCare.gov. According to DC's Department of Insurance, Securities and Banking (DISB), open enrollment for 2027 coverage runs November 1, 2026 through January 31, 2027, about two weeks past HealthCare.gov's January 15 deadline. DC Health Link sets the 2027 coverage start dates, so enroll early and confirm your start date when you apply. DC Health Link's phone number is (855) 532-5465.

2027 income limits: which DC program fits

Marketplace tax credits for 2027 are figured on the 2026 federal poverty guidelines ($15,960 for one person, $33,000 for a family of four). The share of income you're expected to pay for the benchmark Silver plan runs from 2.15% to 10.22% as income rises (IRS Rev. Proc. 2026-26). In DC, most lower-income residents are covered by DC Medicaid or the Healthy DC Plan before tax credits come into play:

The enhanced tax credits of 2021–2025 expired at the end of 2025 and are not back for 2027 under current law, so the 400% FPL cliff has returned: $1 over the line and the credit is $0. For tax years after 2025 there is no cap on repaying excess advance credits, so estimate your 2027 income carefully. Starting January 1, 2027, federal law also limits tax credits to fewer lawfully present immigrants; lawful permanent residents, Cuban/Haitian entrants and COFA migrants remain eligible. Every ACA plan for 2027 caps in-network out-of-pocket costs at $12,000 for one person and $24,000 for a family. For a rough estimate, try the 2027 ACA subsidy calculator or read our ACA income limits guide, then apply on DC Health Link.

2027 DC Health Link rates

DISB approved 2027 individual and small-business rates and posted a final rate list dated September 28, 2026. For individual plans offered in both 2026 and 2027, approved changes vary by carrier and metal level; silver plans, for example, rose 9.5% to 11.2% and bronze plans 7.4% to 10.2%. DISB did not post a single overall average, and HBX had urged DISB not to approve the requested increases. Your own price depends on your plan, age and tax credit, so compare plans on DC Health Link instead of letting last year's plan renew untouched.

Get a Free Life or Supplemental Quote in DC

A licensed advisor can quote term, whole and IUL life insurance, mortgage protection, critical illness and hospital indemnity coverage for Washington, DC residents. Free, no obligation. For ACA health plans, use DC Health Link.