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
DHCF Press Release on Implementation of New Managed Care Plans
The following is a press release from the Department of Health Care Finance that MSDC is reprinting for its members' information.
The Department of Health Care Finance (DHCF) announces the implementation of new managed care contracts, which will set the foundation to expand access to care and improve health outcomes for District residents. DHCF and the new managed care plans – AmeriHealth Caritas DC, MedStar Family Choice DC, and CareFirst Community Health Plan DC (formerly known as Trusted Health Plan) – have worked together in preparation for this milestone in the District’s Medicaid reform efforts. During this readiness phase, we conducted systems testing, virtual managed care organization (MCO) site visits, continuity of care activities, provider and beneficiary outreach, and townhall events to ensure that MCOs were prepared for this transition and beneficiaries were informed about their plan and the services available to them.
As we conclude the readiness phase and officially start the 90-day transition period, which began on October 1, 2020 and extends through December 31, 2020, continuity of care for enrollees is the priority. We are undertaking several steps to ensure that beneficiaries continue to have access to their medical care, prescriptions, and case management.
To minimize interruptions to care or access to prescriptions, all active referrals and authorizations for services and supplies issued prior to October 1, 2020 will remain valid through December 31, 2020. In addition, each MCO will reach out to its new members to conduct a Health Risk Assessment, and those with special health care needs will be contacted by a nurse to receive a comprehensive assessment and individualized care plan. All enrollees who are dissatisfied with their auto-assigned plan may switch plans at any time during the transition phase.
“DHCF is excited to be on the path of reform to realize our vision that all residents in the District have the supports and services they need to be actively engaged in their health and to thrive,” said Medicaid Director Melisa Byrd. “Our top priority during this transition period is ensuring that enrollees understand the benefits available to them and continue to have access to the care and services they need.”
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