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
District Launches Mental Health Emergency Dispatch Program
To better address behavioral health emergencies, Mayor Muriel Bowser announced a new program on Monday to provide targeted resources rather than general police dispatch.
The program trains 911 operators to identify mental health situations which triggers a behavioral health expert to go to the situation. Currently, the program is a pilot that launches next month. During the pilot, the Department of Behavioral Health's (DBH) Community Response Teams (CRT) will mobilize to respond to an emergency when so identified by a 911 call. The operators are currently receiving training on when to dispatch CRT and/or police to these types of calls. If the pilot is considered successful, the District will evaluate what additional resources would be needed to continue the program.
“This program builds on all our efforts to make sure we are providing residents the right care at the right time,” said Mayor Bowser in a press release. “The sooner we can identify what a person needs - whether that is an ambulance, a doctor’s appointment, or in this case, a visit from a behavioral health expert, the sooner we can help them. That’s what this is about: making sure we get Washingtonians the help they need when they call us.”
The pilot is a partnership between Office of the Deputy Mayor for Public Safety and Justice, the Office of the Deputy Mayor for Health and Human Services, the City Administrator, the Office of Unified Communications, and DBH.
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