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
Studies Suggest Children Do Spread COVID-19 With Few Symptoms
Two studies this week suggest what scientists have long suspected - children are equally as able to spread the novel coronavirus even while showing few if any symptoms.
One study was conducted in China and a second was conducted by German researchers. The first study from Wuhan and Shanghai found that children were as third as susceptible to infection but, when schools opened, they had three times as many contacts with adults. The second study was more straightforward - children who tested positive for COVID-19 were found to harbor as much virus - and sometimes more - as adult positive cases. The results were consistent with children hospitalized and those asymptomatic.
The first study was published in Science while the second has yet to be peer reviewed.
The studies gained prominence because of the ongoing debate about reopening schools during the pandemic. All three states in the DMV have closed schools for the academic year (Maryland just yesterday) but other states and countries are considering resuming in-person school. The justification is the seemingly low infection rate among children and the low spread rate, which these studies aimed to address.
As with any study, more research and peer review is needed to make more definitive conclusions.
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