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 and Coalition Request Prior Auth Hearing
Today, MSDC and a coalition of 17 other organizations requested that the Committee on Health hold a hearing on B24-655 (Prior Authorization Reform Act) before the Council's summer recess.
The bill would align DC with other states in reforming the prior authorization process and adopt common-sense reforms modeled by the American Medical Association and other national healthcare organizations. The bill lays out a minimum amount of time a prescription approval is valid, sets qualifications for payer personnel to make prior auth determinations, prohibits a prior auth for cost purposes, and more. The bill is one of MSDC's highest priorities and we have created an action site on the issue.
The letter (seen below) is joined by national and local healthcare, patient advocacy, and health reform organizations. The content is simple in asking for a hearing as the organizations involved have numerous stories on the impact of prior authorization on their members and patients. MSDC has some examples on its prior auth site.
How can you get involved in this issue?
Let MSDC know you want to get involved via our form
Contact your Councilmembers and tell them to support the bill
- Find your Councilmember here
- Use our talking points for your call, visit, or email
- Download, copy, and send our draft language to your Councilmembers
- Learn the best strategies for advocating on an issue by reading our articles here, here, here, and here.
- Download this brochure to provide to patients in your office.
Letter:
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