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
MSDC, MedChi DC Ask Mayor to Sign Minor Consent for Vaccine Bill
Today, MSDC and the Medico-Chirurgical Society of DC sent separate letters expressing the same message - Mayor Bowser should sign the Minor Consent for Vaccinations bill passed by the Council.
B23-171, introduced by Councilmember Mary Cheh, would permit a minor to receive a vaccination on the ACIP recommended immunization schedule without a parent or guardian. The minor, defined as age 11 and above, would need to be deemed by the physician as knowledgeable of the vaccine, any side effects, and that they would be receiving it without parental consent. MSDC was heavily involved in the bill's passage, including consulting on the final language along with the DC Chapter of AAP.
Recently, a campaign by anti-vaccination activists have tried to convince Mayor Bowser not to sign the legislation after it passed the Council by a 10-3 vote. MSDC, MedChi DC, and Immunize DC have all mobilized to provide factual information on why the bill should be signed. MedChi's letter can be seen here. MSDC's email can be seen below.
Dear Mayor Bowser –
Recently we have heard there is a concerted effort asking you to veto the Minor Consent for Vaccination legislation. MSDC supported this bill because it is a good public health measure that will help the District maintain its high immunization levels. A few things to note:
1. The bill will apply only to a select population of minors who (a) can understand medical information about vaccines and (b) cannot receive parental consent for vaccination
2. Physicians will make the final call on whether a minor truly understands vaccines, why they are needed, and any risks
3. A vaccine is one of the safest medical treatments, based on 20 years of research
4. Minors can consent to behavioral health and reproductive health services already without parental consent
This bill helps District residents remain safe with minimal impact on parental rights. We urge you to ignore the disinformation campaign and support the bill.
Sincerely,
The Medical Society of the District of Columbia
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