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
Studies: Childcare Concerns Driving Burnout in Female Physicians
The past two years have been particularly stressful on child caregivers, as everyone recognizes. Throw in a medical career and that stress skyrockets. Now there's new research to back-up this common-sense hypothesis.
Two new studies show that childcare responsibilities for female physicians during the COVID-19 pandemic drive more burnout in their careers. This goes beyond burnout - depression and anxiety are seen at higher levels in female physician caregivers.
The first study comes from the JAMA Open Network. Titled, "Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic," physicians from the University of Michigan used a three-question survey to examine how the pandemic impacted their childcare. Participants also completed a Work and Family Conflict Scale and PHQ-9. Among those surveyed, women were significantly more likely to lose childcare during the pandemic compared to men (84% versus 66%). The gulf in responsibility for childcare responsibilities was greater if both parents were physicians. See the entire study here.
The second study is from the Journal of General Internal Medicine. This survey involved over 3,000 clinicians surveyed between June 2020 and August 2020. The overwhelming majority of respondents (88%) were physicians. Again, women physicians were more likely to report feeling burned out (39%) and decreased wellbeing (51%) than men (28% and 43%). Among respondents with children, 95% reported burnout and not surprisingly, women were more likely than men to report childcare responsibilities. See the study here.
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