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
Council Passes Stimulus Bill With Some Relief for Physicians
While it did not contain all the provisions MSDC hoped, the Council on Tuesday passed a second stimulus bill with some provisions of interest to District physicians.
In a first that's becoming common in the COVID-19 era, the Council met via Zoom for its first ever virtual meeting. The Council considered "consensus" legislation - including new green transit benefit regulations - before debating the stimulus legislation.
Controversially, the bill did not include funding for physician practices impacted by COVID-19. This was the second stimulus where physician support was rejected by the Council, although Councilmember Vincent Gray spoke out in favor of supporting physician and health facilities. MSDC had been advocating for such funding to help keep the healthcare system open during and after COVID-19, including sending a letter to the Council Monday signed by eight physician organizations.
The bill did include the following provisions:
- A 90-day rent deferral that private physicians offices can use to defer rent payments in commercial buildings
- A civil liability provision that could protect physicians, health contractors, and those working to protect the public from COVID-19 from liability except in cases of "gross negligence". MSDC is working with the Mayor's office to further clarify these protections.
- A grant to District hospitals to cover costs until federal funds become available for COVID-19 response
MSDC will continue to work with the Council and Bowser Administration to support all physicians during this public health emergency.
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