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
Report: Entrenched Health Disparities To Blame for African-American COVID Death Rates
A new report by Georgetown University released this week makes clear that existing health disparities are a major cause of the high death rate of African-Americans from COVID-19.
The report, entitled "Health Disparities in the Black Community: An Imperative for Racial Equity in the District of Columbia", was published by the university's School of Nursing & Health Studies. Christopher King, PhD, FACHE, chair of the Department of Health Systems Administration, was the report's lead author.
“Black residents in our city face a disproportionate burden of disease, such as cancer, diabetes, heart and respiratory diseases, and obesity,” King said. “These health disparities result from long-standing injustices and makes the African American community much more vulnerable to a highly infectious virus like COVID-19.”
Some of the study's findings include:
- There is a 15-year difference in the life expectancy between residents in Ward 3 and Ward 8
- Residents from wards with more African-American residents are more likely to be hospitalized for preventable health conditions
- African-Americans are three times more likely to be obese than white residents
- The rate of diabetes is seven times higher in the African-American population than whites
- The medium household income for African-Americans ($43,546) is three times less than whites ($135,363)
For more information about health equity in medicine in the District, MSDC offers the following resources:
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