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 COVID-19 Task Force Convenes To Tackle Tough Conversations
On Thursday, the MSDC COVID-19 Task Force convened its first meeting to discuss how the physician community can address some of the largest issues facing the District during COVID-19.
On April 6, the MSDC Board passed a motion to create a task force that would examine the major questions around the COVID-19 emergency in the District, provide medically-sound guidance for the District, and give diverse perspectives to assist entities in making decisions during the emergency.
The COVID-19 Task Force is chaired by Raymond Scalettar, MD. Dr. Scalettar is a rheumatologist with a decades-long record of service to the House of Medicine, the residents of the District, and U.S. Air Force. He also served on the MSDC AMA Delegation and American Medical Association Board of Trustees.
In addition to Dr. Scalettar's outstanding expertise, the Medical Society of DC is proud to have the following individuals serve as Task Force members:
- Alan Cashell, MD
- Laurie Duncan, MBBS
- Alice Fuisz, MD
- Joseph Gutierrez, MD
- Tenesha Moody, MD
- Kirstiaan Nevin, MD
- Donald O'Kieffe, MD
- Ashesh Patel, MD
- Theresa Stone, MD
- J. Desiree Pineda, MD
- EW Emanuel, MD
On Thursday's Zoom call, the Task Force considered a number of issues and made some recommendations to the Society's leadership. The notes of the conversation can be found here but some recommendations made include:
- The District must create a COVID-19 testing site specifically for healthcare workers with rapid results
- The District must permit self-referrals for physicians seeking COVID-19 testing
- DC Health must liberalize requirements to permit International Medical Graduates (IMG) temporary medical licenses or permission to work in a supervised hospital setting during the public health emergency.
The next meeting of the Task Force is Thursday, April 23 at 5 PM. Members interested in observing or participating may request an invitation from Robert Hay at hay@msdc.org.
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