Health Equity
Medicaid Enrollment Touches 39% of the Residents of The District of Columbia; DC’s 70/30 FMAP is Vital for the Maintenance of Health & Human Services
A reduction in the District’s FMAP would not lead to long-term government savings and would have a ripple effect throughout the entire health system in the DMV, crippling access to care for not only Medicaid beneficiaries but also all those who live, work, and visit the District of Columbia, including members of Congress and their staffs.
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Why does DC receive an Enhanced FMAP Rate?
The DC FMAP rate of 70% established by the Revitalization Act resulted from bipartisan analysis, discussion, and negotiation by Congressional leadership aiming to balance fairness with the District’s restricted ability to generate revenue. Congress recognized that the District of Columbia faces unique financial challenges due to its non-state status and the significant amount of federally-owned land within its boundaries. The District is unable to tax non-residents’ earnings, so these workers pay no taxes to support the infrastructure and services, such as roads, public safety and emergency services that they benefit from in the District. The District is also unable to tax up to 40% of the real property within its borders due to statutory restrictions.
Why are we concerned about DC's FMAP now?
Members of Congress have proposed reducing the DC FMAP to the statutory minimum for all other states, which is currently 50% (but could be reduced even more). Such a change would impact every physician and every practice, regardless of type, location, and payers contracted. Even practices who take no insurance will not be able to send patients for specialist care, hospital admissions, or other types of care.
What can MSDC members do?
- If you know a member of Congress or staffer, reach out to them and share how DC cuts will hurt your patients.
- Share your relationships and outreach with hay@msdc.org so we can help coordinate advocacy efforts.
- Email hay@msdc.org if you would like to be paired with a physician member of Congress office and trained by MSDC staff on how to reach out.
Resources
- DC FMAP cut fact sheet
- California Medical Association fact sheet on Medicaid cuts
- MSDC and healthcare association letter to Congress arguing against DC FMAP changes.
- MSDC original story on Medicaid changes.
News, Statements, and Testimony on Health Equity Issues
MSDC's Physician Health Program is Here To Help During COVID-19
"Wanted to check in since it’s been a week. I feel GREAT!"
These are the words of a resident physician who MSDC intervened on last week. When no psychiatrist was available to help a resident who was struggling with anxiety and depression exacerbated by the COVID-19 pandemic, MSDC stepped in. Our clinical case manager Steve Carerras triaged the resident and spent an hour on the phone providing supportive therapy. We were then able to get the resident in with me for formal psychiatric assessment and treatment plan.
Many who think of the MSDC Physician Health Program (PHP) equate it only to physicians who have addiction problems and/or severe pathology or impairment. That is if they are even aware of the program. However, the MSDC PHP offers so much more. Our aim is to help any physician who is in distress. This includes:
mental health problems (large or small)
- behavioral/communication problems
- substance use problems
- cognitive problems
- physical disability
We offer a range of services including on-site interventions and triage, brief counseling/support, referral for comprehensive assessment (when indicated), referral to treatment providers who work specifically with physicians, monitoring for physicians in recovery and advocacy to regulatory bodies and hospital staff. Our goal is to keep physicians who experience challenges in our workforce practicing the best and safest medicine possible.
In order to support our work, I ask that you consider joining the MSDC. You membership dues help us offer these services to physicians across the District. Under the leadership of our current president, Dr. Pineda, the MSDC is looking to expand our health and wellness services to provide brief counseling and coaching to physicians who may not need intensive services of the PHP but still need help.
Every time I help a physician return to practice, whether it be this resident in crisis or a mid-career physician who has had to leave medicine for detox and rehab, it gives me great joy. Please join me in supporting the MSDC and in doing so supporting physician health across the District of Columbia in these tough times.
Stay safe;.
Charles P. Samenow, MD, MPH
Chair, MSDC Physician Health Program
Associate Professor, Department of Psychiatry and Behavioral Sciences
Medical Faculty Associates
George Washington University School of Medicine
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