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
COVID-19 Task Force Says DC Should Permit Frequent Physician Testing
The MSDC COVID-19 Task Force held its fourth meeting on Thursday and issued a strong recommendation that the District facilitate the ability for physicians to be tested frequently for COVID-19, even when asymptomatic.
The recommendation came from a discussion on the economic consequences of the public health emergency on physician practices. Task force members shared concerns that the economic losses due to COVID-19 endanger many physician offices. Even when physician offices reopen, the lack of PPE available may expose physicians and staff to infections. An asymptomatic physician can be an extremely effective spreader of COVID-19, so repeated testing is critical.
Other issues and recommendations from the meeting include:
- Concerns about people held in prison pre-trial being unnecessarily exposed to potential infection
- Discussions about the gaps of using temperature checks to determine infection
- Deciding that DNR orders and advanced directives are a changing conversation during COVID-19 and requires further discussion
- Continued work on bringing forward the over representation of African-Americans and Latinos in COVID-19 infection and death statistics, and how to address these issues
The next meeting of the COVID-19 Task Force is June 4 at 5:00 PM. Anyone interested in participating can contact Robert Hay Jr. (hay@msdc.org) for an invitation.
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