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
CDC - Double Masking and Tight Masks Dramatically Reduces COVID Spread
On Wednesday, the CDC published new research that shows medical plus cloth masks, or tighter fitting masks, can reduce the spread of COVID-19 by over 90%.
During January 2021, the CDC conducted two experiments to see the effectiveness of double masking and knotting and tucking medical procedure masks. In the first, using a device to simulate a person coughing, scientists reviewed the following double masking combinations to gauge protection from aerosol particles (% of particles blocked in parens):
- three ply medical mask (42%)
- three ply cotton mask (44.3%)
- three ply cloth mask over a three ply medical mask (92.5%)
The second experiment used ten mask combinations to gauge how two modifications to medical procedure masks could reduce aerosol emission. These combinations included no masks, single masks, and knotting/tucking the mask. By knotting and tucking, the report meant masks where there was a way to tighten or tie a knot of the ear loop near the face. The research found transmission of COVID was reduced 83% in double-masked situations and 62.9% in situations when the individual wore a knotted mask.
Based on this research, the CDC emphasized the importance of wearing well-fitting masks. Wearing masks that fit closely and/or have two levels of different material protections greatly reduce infection. The report concludes:
Until vaccine-induced population immunity is achieved, universal masking is a highly effective means to slow the spread of SARS-CoV-2 when combined with other protective measures, such as physical distancing, avoiding crowds and poorly ventilated indoor spaces, and good hand hygiene. The data in this report underscore the finding that good fit can increase overall mask efficiency.
The report makes no definite policy requiring mask types. However, this research comes as some European countries are now requiring residents to wear medical masks in public to reduce the spread of the COVID-19, especially the new mutations.
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