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
Physicians Seeing Increased Cancer False Positives Due to Vaccine Side-Effect
People receiving a COVID vaccine are showing enlarged lymph nodes, which may be mistaken for cancerous growth when it is nothing more than a temporary side effect.
A study published in the American Journal of Roentgenology notes that patients with auxiliary adenopathy identified on breast imaging after receiving a COVID vaccine are increasing. This phenomenon has been noted on social media by MSDC member Anjali Malik and others. While swelling is a normal side effect after being vaccinated in general, mammograms and chest scans can show white blobs that are easily confused for cancer.
According to the New York Times, enlarged lymph nodes are not listed as a side effect in FDA documentation for the Johnson & Johnson vaccine. The Moderna study showed 11.6% of patients reported swollen lymph nodes. The Pfizer had a low reported incidence but the Times notes radiologists believes incidents are higher than reported.
The Society of Breast Imaging makes a series of recommendations for helping patients navigate this situation including:
- Physician offices should document patients' vaccine information on an intake form.
- Offices should consider including a warning statement on forms about the impact of the COVID vaccine on the scan.
- Physicians should consider scheduling a second scan 4-12 weeks post-visit.
For patients undergoing cancer treatment in one breast, the CDC recommends receiving the vaccine in the opposite arm or thigh to minimize false diagnosis.
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