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 Updates PPE Requirements for Healthcare Facilities
This week DC Health updated its guidance for health care personnel to wear personal protective equipment (PPE) in a healthcare facility (HCF).
Similar to the September 15 guidance, as well as previous guidance, DC Health encourages aggressive use of PPE to ensure safety and limit disease spread. All HCPs should wear protective masks at all times within a facility and must wear eye protection in patient care areas or where 6 feet of distance cannot be maintained. This means patient waiting and reception areas must have personnel with eye protection (goggles are still not considered safe).
Importantly, healthcare employers must provide PPE usage education to staff and conduct routine audits of proper PPE usage by staff. The guidance includes a CDC link for an education resource but does not spell out audit processes.
The guidance does mention that facilities with adequate PPE must follow manufacturers' usage guidelines for the equipment, while those facilities with "reusable" PPE must ensure it is cleaned, decontaminated, and stored after use. The guidance also says respiratory protection must be worn when providing care to a patient or when care areas where social distancing is not possible. This includes break rooms or nurses' stations.
You can read the entire guidance here. MSDC also has an arrangement with ActionPPE to provide high quality PPE to physician member offices. You can order or increase your PPE supply through https://actionppe.org/msdc and MSDC members can get a 5% discount using the special membership code. Call or email MSDC to receive the code.
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