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 Racial Equity Office Issues Vaccine Recommendations
The District's new Council Office of Racial Equity (CORE) issued a report this week recommending how the District's COVID vaccine distribution process could be more equitable.
Ward 5 Councilmember Kenyan McDuffie requested the report from CORE after media reports that Black residents were lagging in vaccination rates. As of February 20, only 19% of residents who had received at least one vaccine dose were Black. A quarter of doses given to residents 65 years or older were for Ward 3 residents, and only 5% were to Ward 8 residents.
The report outlines four areas causing vaccine inequality:
- Availability of vaccines
- The registration process
- Access to vaccine sites
- Policy barriers (specifically the inability of independent pharmacies to vaccinate)
To address some of these issues, the report highlights initiatives in other states that the District should consider adopting, including:
- Create specific resources addressing historic abuse of minority communities in medicine to encourage vaccine confidence
- Empowering independent pharmacists to vaccinate populations
- Partner with pharmacies to distribute leftover vaccines
- Utilize the Medical Reserve Corp to mass vaccinate in underserved areas
- Utilize a warehouse storage process to shorten the distance to distribute vaccine doses
You can read the entire report here.
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