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 Launches New COVID Vaccine Website
A week after its vaccine system faced criticism for technology failings, the District announced a new vaccine registration system aimed at streamlining the appointment process.
The system launches Wednesday and allows residents that fit in the current vaccine categories to sign-up to receive an appointment. Officials stressed the system will not be first-come, first-serve. The system will select individuals based on a number of factors and randomly invite them to book an appointment. The individual will have 48 hours to do so, or be returned to the waitlist for another invitation. If you fail to register for a vaccine appointment after 3 contacts, you will need to re-register.
While the system opens Wednesday, the District anticipates the first wave of invitations going out on Friday via email, calls, or texts. Also, while they can conceivably register now, the District is asking residents not eligible for vaccine appointments to not register. The system theoretically will allow them to register, but it will not add them to the invite list and will not save them time when their tier is eligible.
While the District is saying not everyone who wants a vaccine at the moment can be, they do promise that everyone who registers will be vaccinated, even if it takes months. The District has begun allocating its vaccine doses received from the federal government: roughly one third go to hospitals for their patients, 15,000 go to vaccinate.dc.gov, and 3,000 go to "special initiatives". Further, the eligible doses will be divided to 40% for 65+ in age, 40% for those with pre-existing conditions, and 20% to eligible workers.
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