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
MSDC, Healthcare Community Push Passage of Temporary License Waiver Extension
Working with the local healthcare community, MSDC and its members won a big victory with the Council to extend temporary license provisions.
With the end of the public health emergency, the provision permitting temporary licensure of out-of-state providers had an end date of September. The original public health emergency permitted providers licensed in other states to act as temporary agents to fill healthcare needs in the District, provided they acted within their scope, and were licensed and in good standing in their state, among other requirements. This helped patients receive more services despite COVID straining the health care system, including via telemedicine. These providers needed to apply for a license in the 60 days between the end of the public health emergency and the waiver's end.
MSDC and other healthcare associations were concerned that the 60 day window was not sufficient to license these emergency providers. The turnover in the healthcare industry, the recent increase in COVID cases, the return of children to schools, and the long wait times for licenses across the sector had the industry worried about a healthcare provider shortage at a time of enhanced healthcare needs.
Councilmember Vincent Gray introduced the Uniform Emergency Volunteer Health Practitioners Emergency (and Temporary*) Declaration Resolution of 2021. The legislation extends the 60 day grace period to the end of December, 2021. This allows healthcare practitioners additional time to apply for and receive a license. The legislation passed the Council on Tuesday and is awaiting the Mayor's signature.
MSDC is thankful to Councilmember Gray, his staff, and the entire Council for taking this action. We will continue to work for a permanent solution to the regional licensure issue by pushing the District government to enter a regional licensure compact or reciprocity agreement with Maryland and Virginia.
* - What's the difference between emergency and temporary legislation? Learn more here.
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