The District of Columbia faces a broad array of health problems, largely because of the high levels of poverty among its residents. Recent changes, however, have given the District an opportunity to address these problems by expanding insurance coverage while also addressing the needs of the institutions that serve the uninsured. In the past few years the District has taken major steps toward resolving its budget problems. In addition, the federal government has increased the Medicaid matching percentage from 50 percent to 70 percent. As a result, the District has been able to expand Medicaid coverage; an additional expansion is planned for next year, and other expansions are under consideration.