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
Copay Accumulator Bill Passes DC Council
On Tuesday, the DC Council voted unanimously to pass B25-141, the Copay Accumulator Amendment Act.
This legislation is one of the physician community's top priorities and a great victory for MSDC members.
B25-141 as introduced would require health insurers to apply discounts, financial assistance, payments, product vouchers, or other reductions in out-of-pocket expenses made by or on behalf of a member when calculating the member’s coinsurance, copayment, cost-sharing responsibility, deductible, or out-of-pocket maximum for a covered benefit.
The legislation passed the Committee on Health on March 20 and had its first Council reading in April. Last year the bill had a hearing before the committee and included multiple physicians and patent advocates speaking in favor of the legislation.
The next step for the bill is for the Mayor to sign the bill before it is enrolled and sent to Congress for a review period.
Passing this legislation in May means two major victories for physicians: passing the Copay Accumulator Amendment Act and the hearing on prior authorization legislation. MSDC members interested in learning more are invited to join the MSDC Advocacy Committee.