What to know about the 2027 DC budget April 15, 2026

Presented on April 10, 2026, Mayor Bowser’s $12.7 billion FY2027 budget was built around a $1.1 billion gap—driven in part by $172 million in rising Medicaid costs attributed to growth in special populations, provider rate increases, and overall enrollment. The publicly presented budget makes several direct healthcare commitments while also imposing targeted cuts that will ripple through the District’s health and human services ecosystem. The full impact will be known once we analyze the details of the budget in the coming days:

• Healthcare investments: The budget’s most notable new healthcare item is $9 million to add dental and vision benefits for Basic Health Plan (Healthy DC Plan) and DC Health Care Alliance participants. The budget also commits $1 million toward site evaluations to keep Children’s National Hospital within the District, recognizing its role as the second-largest private employer in DC with 8,800 employees and a $3 billion economic footprint. Medicaid and Alliance coverage is preserved for all current participants, and childcare worker healthcare funding of $12 million is maintained within the $429 million early childcare investment package.
• Healthcare-related cuts and constraints: The budget pauses new medical leave claims under DC’s Universal Paid Leave program for one year, saving $95 million, with coverage reduced to parental and prenatal leave only. The Substance Use Disorder community support program absorbs a $9 million reduction through new cost controls on community-based services.