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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.

 

What Medicaid Cuts Actually Cost

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

 

 

Mayor Orders Payers to Cover More COVID-19 Testing

Aug 25, 2020, 13:24 PM by MSDC Staff
Mayor Bowser expands the categories of people who are eligible for covered COVID-19 testing.

Recognizing the importance of robust testing, today Mayor Muriel Bowser and the Department of Insurance, Securities, and Banking (DISB) issued an order requiring health insurers to cover the cost of COVID-19 testing for more categories of at-risk individuals.

The measure, seen here, requires all carriers offering health plans in the District to "cover testing to diagnose COVID-19 for individuals who meet the standards" defined by DC Health. People seeking tests will not require prior authorization or a referral from a physician to receive a test and have it covered by their insurance. However, the mandate does not extend to covering a test to an employee returning to the office after telework, though it does encourage such coverage. 

Prior to today, DISB had required payers to cover tests that fell under CDC guidance for testing. Now, insurers must cover one COVID-19 test per week for some asymptomatic people in high-risk settings, are at-risk for complications, or have been exposed to a recently diagnosed person. 

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