Program eligibility

(a) An individual shall be eligible for the Program if the individual: (1) Has resided in the District for at least 6 months at the time of application to the Program; (2) Resides in a household having a gross household income not exceeding 400% of the federal poverty guidelines as updated periodically in the Federal Register by the United States Department of Health and Human Services under the authority of 42 U.S.C. § 9902(2); and (3) Does not qualify for: (A) The DC HealthCare Alliance; (B) Medicare; (C) Medicaid; or (D) Other federal health-benefits programs; and (4)(A) Has not had health insurance during the 6-month period prior to application to the Program; (B) Has had health insurance during the 6-month period prior to application to the Program but the insurance was terminated due to: (i) The loss of employment; (ii) A death of a spouse, domestic partner, or family member who maintained the individual as a beneficiary on a health-insurance plan; (iii) Changes in student status, including graduation, a leave of absence, or reduction to part-time study; (iv) A change of employment to a new employer who does not provide group health insurance; (v) A legal annulment, separation, divorce, or the dissolution of a domestic partnership; (vi) The loss of financial eligibility under Medicaid or the DC HealthCare Alliance; (vii) The cancellation or discontinuation of a group health insurance contract by a health insurer; or (viii) Any other reason as determined by the Mayor; or (C) Has health insurance but the annual cost to the individual is deemed unaffordable, as determined by the Mayor. (b) Eligibility for the Program shall not be subject to any pre-existing condition exclusions.