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
Bowser Administration Announces New Howard, St. E Hospitals
In the midst of a pandemic that is exposing health inequities, the Bowser Administration will hold a press conference today announcing two new hospitals that could help address some of those inequities.
First, the administration will announce a final deal to build a hospital on the campus of St. Elizabeths with Universal Health Services (UHS). The new hospital will be an extension of George Washington University Hospital (operated by UHS) and includes opening urgent care clinics "East of the River". The new hospital will replace United Medical Center and open in 2024. It will contain a level-three trauma center, obstetrical services, cancer care services, and 136 beds.
Second, the administration will share details about Howard University and Adventist HealthCare new hospital. The new building will be built on university grounds and the old hospital complex will be redeveloped as part of the university campus. The deal allows Adventist HealthCare to modernize a hospital and health center that has served as a prestigious training hospital, especially for African-American students.
The deals hope to begin addressing some of the health inequalities that exist in the District. The COVID-19 public health emergency has been particularly virulent in the African-American community, with around 80% of deaths in the District are African-Americans. While new hospitals will not address all of the health concerns for populations in need, they are an important part of a robust and effective health care system.
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