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 Ends Public Health Emergency - Now What?
On Saturday, Mayor Muriel Bowser issued Mayor's Order 2021-096 to update and extend the District's Public Emergency but end the District's Public Health Emergency. Both had been in effect since March 11, 2020.
The Mayor is continuing the public emergency to permit some flexibility in handling changes to the COVID-19 pandemic. These include continuing to receive federal reimbursement, adjusting government personnel, implementing preventative measures for medically vulnerable people, and establishing vaccination/mask requirements.
The end of the public health emergency does end a number of allowances to address the pandemic. Specific to medicine are two deadlines of note. First, healthcare professionals operating under the licensure waiver for DC Health have 60 days to continue operating before their permission expires. The intent is to allow providers time to apply for a full license, although MSDC has heard wait times for licenses often exceed this time. MSDC is working with other associations and DC Health to create new pathways to retain these providers. Second, the Certificate of Need waiver expires August 24.