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
Re-Open DC Advisory Group Issues Recommendations on Path Forward for District
On Thursday, the Mayor's special task force to think through how DC can recover from COVID-19 issued its final report. The recommendations span social, educational, medical, and entertainment areas.
Most of the reports about the recommendations focus on the impact on the social life of residents as well as plans for schools. Undoubtedly these are significant. For example, recommendations for restaurants include having dinners include information such as full name and time entering when eating at a restaurant, to assist with contact tracing.
The medical recommendations primarily fall under two areas: Human Services, Social Services, and Health Committee; and Public Health Innovation and Workforce Committee. That said, health recommendations were included throughout.
Recommendations of note from the Equity and Vulnerable Populations Committee
- Underserved communities should be a focus for contact tracing, medical care, and medical literacy programming
- Medical providers and other frontline workers should have 24/7 access to mental and behavioral health services
- Telehealth services should be accessible to all and covered by insurance (assumption being this is individual/group plans)
Recommendations of note from the Human Services, Social Services, and Health Committee
- Stage 1 of re-opening would include a reliance on "alternate" care models and care would be prioritized by urgency and necessity of face-to-face care
- All elective or non-emergency surgeries and procedures would be permitted at Stage 2, with only procedures with low PPE usage and timely procedures permitted in Stage 1.
- Preventative care would be promoted in Stage 1 BUT must be done safely
- The District should consider creating a funding pool to purchase PPE for front line workers
- The District should promote digital equality to ensure all residents can access telehealth services.
- The District should reclassify telehealth equipment as "durable medical equipment" for Medicaid reimbursement
- The District should allow practitioners to practice in DC if they have a license in another state and are undergoing the DC licensure process.
Recommendations of note from the Public Health Innovation and Workforce Committee
- The District should create public-private partnerships to ensure a comprehensive testing strategy across the District
- The District should consider subsidizing PPE for non-government organizations serving at-risk populations
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