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
Five easy ways in May to reduce prior auths in DC
May is a HUGE month in the fight to reduce the prior auth burden in DC. Imagine a world with fewer insurance denials and when prior authorizations happen, they are more targeted and medically sound.
Fantasy? Not if you take a few minutes this month to do one or more of the following
- Testify on May 24 at the prior authorization bill hearing. It's easy and convenient. The hearing starts at 9:30 AM and is completely virtual. MSDC can even sign you up if you ask.
- Learn more about prior auth changes (and potential changes) by joining Dr. Patience White for a discussion on the state of prior authorization in DC. She will be joined by Council staff and the AMA to discuss the hearing and other updates.
- Want to testify at this hearing or a future one, but don't know how? MSDC President Dr. Susanne Bathgate is having a brief lunch session on testifying before the Council - learn more here.
- Let MSDC know you're interested in this issue. Seriously - that's it. We can't keep you up to date if we don't know.
- Sign our sign-on letter here.
We've been talking A LOT about prior authorization recently, and it is because our DC bill puts practical but effective limits on when insurers (private and public) can slap a prior authorization on your prescriptions. See here how.
But this great new reality won't happen if physicians, patients, and practices don't act now. The good news is it is easier than ever to make a difference.