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 President Susanne Bathgate Calls for License Reciprocity “ASAP” – and Gets It
In a victory for physicians, MSDC has helped pave a pathway for expedited medical license reciprocity between Washington, DC, and neighboring Virginia and Maryland.
Today, the District of Columbia Board of Medicine announced that it and the Maryland State Board of Physicians and the Virginia Board of Medicine, “have entered into an agreement to establish reciprocity amongst the parties to facilitate the expedited reciprocity licensure of physicians practicing within the three jurisdictions.”
This announcement comes on the heels of MSDC President Susanne Bathgate’s forceful testimony before the DC Committee on Health, when she recently called for “regional license reciprocity as soon as possible.”
Today Dr. Bathgate stated, “MSDC has long loudly championed the need for a streamlined medical licensing process with neighboring Virginia and Maryland, and we have worked diligently over many years to bring together our counterparts across the DMV. Today the DC Board of Medicine announced that it has entered into agreement with the medical boards in Maryland and Virginia to develop licensure reciprocity between our neighbors. On behalf of our hard-working physicians who have led the call for this change, we thank the Board for this first step. MSDC will continue to work with the DC Board of Medicine and neighboring jurisdictions to ensure that the pathway implementation is smooth and efficient for District physicians.”
The current medical licensing process between the District of Columbia, Maryland, and Virginia is cumbersome, onerous, lengthy and has long plagued physicians looking to be regionally licensed. The three states each have provisions in statute to permit this, but the implementation and coordination has been lacking. In response to continued physician frustration, MSDC pushed for collaboration between the District, Maryland, and Virginia.
Allowing quicker licensing for area physicians not only saves time, money, and stress for the regional healthcare system, but also benefits patients in need of care and meets the needs of modern hybrid work settings. MSDC has consistently called for the removal of needless barriers to physician licensure and patient care.
Details about the new system have not been announced by the District, but do appear on the Maryland Board of Physicians and Virginia Board of Medicine. MSDC will continue to monitor the implementation in the District and will work with the Department of Health to ensure that the process is properly executed.
The announcement from DC Health issued on March 15, 2023, appears below.
RE: DMV Reciprocity Pathway
Dear District of Columbia Board of Medicine Stakeholder,
The District of Columbia Board of Medicine is excited to announce a new licensure pathway for US/Canadian-educated physicians. The District of Columbia Board of Medicine, the Maryland State Board of Physicians, and the Virginia Board of Medicine have entered into an agreement to establish reciprocity amongst the parties to facilitate the expedited reciprocity licensure of physicians practicing within the three jurisdictions.
We understand that obtaining a license can be a lengthy process for physician applicants and due to the close proximity and geographical relationship of the District of Columbia, Maryland, and Virginia, many physicians need licensure in all three (3) jurisdictions. The purpose of the expedited pathway allows the Board to minimize the administrative burden on the applicant and staff, while still concurrently ensuring minimum qualifications are met to protect the public.
For more information, please visit the Boards’ web pages: