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
Join the MSDC Prior Auth Sign-On Letter
MSDC wants to make it clear - a hearing on prior authorization is excellent, but it is not the end. The hearing must lead to meaningful reform via legislation being marked up and sent to the Council.
That's why MSDC is asking physicians, practices, and organizations to join our letter. The letter does two things - it thanks the committee for holding the hearing and urges a quick mark-up of the bill. The sooner the bill works its way through DC's long legislative process, the quicker reform can be enacted.
The text of the letter is below and on the sign-up form.
The deadline to sign the letter is May 19 by 5 PM ET. That will allow us to deliver the letter to the committee before the hearing.
Physicians and supporters are encouraged to testify at the hearing for B25-124 on May 24. Those interested in learning more or seeking assistance from MSDC can contact hay@msdc.org or call 202-466-1800.
Sign on to letter
May 23, 2023
The Honorable Christina Henderson
Chair, Committee on Health
Council of the District of Columbia
1350 Pennsylvania Ave NW
Washington DC 20004
Dear Chair Henderson,
We, the undersigned
physicians and healthcare professionals, thank you for holding a hearing on B25-124, the Prior Authorization Reform Act. At the hearing, you will hear numerous stories of how prior authorization is harming patient care, driving up health care costs,
and burning out physicians and providers. For these reasons, we urge your committee to mark up this legislation as soon as possible and send it to the full Council.
A recent American Medical Association (AMA) physician survey on prior auth
showed that:
• 93% of physicians report care delays because of prior authorization.
• 80% of physicians report that prior authorizations can at least sometimes lead to treatment abandonment.
• 1/3rd of surveyed physicians
report a prior authorization led to a serious adverse event for a patient
• Physicians and staff spend almost 2 business days (14 hours) each week completing prior authorizations.
We thank you for holding a hearing on this bill
because you and your colleagues need to hear our stories about how prior authorizations negatively impact physicians and medical practices across the District. After the hearing, we ask you to work as quickly as possible to markup the bill so DC can
join 40 other states in reforming the prior authorization process.
Sincerely,