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
DC Health Releases New Guidance on Healthcare Workplace and Patients
On Tuesday, DC Health released two new COVID-19 guidance documents aimed at healthcare facilities.
The first guidance document, which you can read in its entirety here, focuses on employers of healthcare personnel (HCP) and all healthcare settings. Some of the updated guidance in the document includes:
- HCPs who meet COVID exposure criteria or community exposure EVEN if asymptomatic should be restricted from in-person work.
- All facilities must implement universal use of eye protection by HCPs in any area where patient care services are provided AND where 6 feet of distance cannot be maintained within the facility.
- Safety glasses are not considered appropriate eye protection.
- All HCPs should be screened at the beginning of their shift. If a COVID-19 positive occurs in the facility, staff should be screened at the beginning, middle, and end of their shift. These tests should be documented.
- The guidance includes a chart on how facilities must respond if an HCP is exposed to COVID-19, either at work or through community spread.
- Strategies for mitigating exposure shift to symptom-based and away, generally, from testing-based.
The second set of guidance focuses on "recommendations and requirements for the discontinuation of COVID-19 transmission-based precautions for suspected and confirmed COVID-19 cases in a healthcare setting". Similar to the previous guidance, DC Health recommends moving to a symptom-based strategy rather than a test-based strategy for most patients. You can read the entire new guidance here.
Importantly, DC Health says the following: "If a patient is on quarantine and has a negative COVID-19 test result during their quarantine period, the patient must still complete the 14-day quarantine".
MSDC will update this space with more information as it becomes available.
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