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.
.png?sfvrsn=9ac2d21b_0 "What Medicaid Cuts Actually Cost")
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
Annual Enrollment Period Opens October 15, But Certain Residents May Enroll Now
Content provided by UnitedHealthcare Community & State District of Columbia
The AEP (Annual Enrollment Period) is approaching and this year the District Dual Choice Program is an option for individuals who reside in the district and who qualify for both Medicaid and Medicare.
The Medicare Annual Enrollment Period (AEP) happens once a year in the fall. That’s when anyone who’s eligible can change their health plan. But if you qualify for a Dual Special Needs Plan, you may not have to wait. You may be able to enroll right away.
You may be eligible to enroll today if you:
- Are 65 and newly eligible for Medicare or is 21 and older with a qualifying disability.
- Are retiring and losing your current coverage.
- Have moved out of your current Medicare plan’s service area.
- Have a chronic condition like diabetes or chronic heart failure.
- Receive Medicaid benefits.
Dual health plans include extra benefits and features to help those with Medicaid and Medicare. Some of these benefits, like credits to buy OTC products and covered groceries, transportation assistance and prescription drug coverage, you may know about. But dual health plans also offer many other benefits and features that may surprise you.
Here are a few surprising benefits of District Dual Choice Program.
- Care Coordination - Health care can be confusing for anyone. But it may be more difficult for those with Medicaid and Medicare. Some dual health plans may offer you a personal care coordinator. That’s someone who can help you:
- Understand your Medicaid and Medicare benefits.
- Manage your doctors, specialists, and care services.
- Get the services you need to feel as healthy as you can.
- Personal Emergency Response System - Some dual health plans offer enrollees a personal emergency response system (PERS) at no extra cost. In an emergency, the PERS system quickly connects the enrollee with a trained operator. The operator can give assistance over the phone and send help if needed. PERS is a life-saving benefit that’s available 24 hours a day with dual health plans from UnitedHealthcare.
- You May Be Able to Enroll Right Away - One of the biggest benefits of a dual health plan is that you may not have to wait to enroll. Most people can only change their Medicare plan during the Medicare Annual Enrollment Period (AEP) in the fall. But if you qualify for Medicaid and are enrolled in Medicare, you may be able to enroll during the first 9 months of the year in a Special Enrollment Period (SEP).
For more information, visit UnitedHealthcare Community Plan of District of Columbia Homepage.
Leave a comment