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
Vaccine Rollout, Budget Hearings Offer Opportunities for Physician Advocacy
The announcements by the DC Council and DC Committee on Health of hearings in the next few months offer physicians an opportunity to speak up on important healthcare issues.
Earlier this week, Committee on Health Chair Vincent Gray announced a two-day hearing on the COVID vaccine rollout strategy. In the hearing notice (see here) the committee states it will, "examine the District’s COVID-19 vaccination process, and will be conducted over a two-day period... Issues that will be discussed include: the effectiveness of the District's vaccinate.dc.gov enrollment portal and call-in number, the enrollment process, communication and outreach, and the equitable prioritization of vaccines."
Anyone interested in testifying is asked to contact the committee by January 28 at 6 PM. Any physician who wishes to testify and would like assistance from MSDC can contact Robert Hay at hay [at] msdc.org or call the MSDC hotline.
In addition, the Council announced this week its 2020-2021 Performance Oversight and 2022 Budget Hearing schedules. These hearings are opportunities for individuals and organizations to draw attention to healthcare issues that are either underfunded, unfunded, or not in the Council's awareness; or to provide comments on the performance of government agencies. Last year, MSDC Board member Laurie Duncan, MBBS, testified during the DC Health performance hearing on the importance of partnership in handling physician wellbeing. Then-President Desiree Pineda also testified in the summer on specific line items in the District budget including the Health Professionals Loan Repayment Program.
The schedule for health agencies is below:
Oversight Hearings
Friday, February 12 – 9 am - 6 pm
Health Benefit Exchange Authority/Department of Behavioral Health
Thursday, March 4 – 9 am - 6 pm
UMC/DMHHS/Department of Health Care Finance
Friday, March 19 – 9 am - 6 pm
Department of Health
Budget Hearings
Friday, April 9 – 9 am - 6 pm
UMC/DMHHS/Department of Health Care Finance
Wednesday, April 28 – 9 am - 6 pm
Department of Health
Friday, April 30 – 9 am - 6 pm
Health Benefit Exchange Authority/Department of Behavioral Health
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