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 Board Member Testifies For Free Prostate Cancer Screenings
MSDC Board member and presumptive 2024 President-Elect Dr. Dock Winston testified today that DC insurers should be required to cover prostate cancer screenings.
MSDC policy supports insurers covering health screenings and treatments that lead to better patient outcomes and healthier people. B25-229, the Cost Free Coverage for Prostate Cancer Screening Amendment Act, would provide cost-free coverage of one prostate-specific antigen test and digital rectal exam per year. It would also prohibit any health insurer from imposing a deductible, coinsurance, copayment, or other cost-sharing requirement for prostate cancer screening. As a urologist, Dr. Winston feels especially passionate about this issue.
The DC Council's Committee on Business and Economic Development held a hearing on B25-229 and two additional bills. The legislation is co-introduced and co-sponsored by the entire Council, which makes its passage likely.
Dr. Winston's testimony (seen below) is an example of how physicians can be key health witnesses on important issues, and shape how a bill is considered. If you would like to learn how you can testify or advocate before the Council, contact Robert Hay (hay[at]msdc.org).
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September 28, 2023
Councilmember Kenyan McDuffie
Chair, Committee on Business and Economic Development
1350 Pennsylvania Ave NW
Washington, DC 20004
Dear Chair McDuffie,
The Medical Society of the District of Columbia (MSDC) is the largest medical organization representing metropolitan Washington physicians in the District. We advocate on behalf of all 11,000 plus licensed physicians in the District and seek to make the District “the nation’s model for patient care and physician practice”.
I am providing comments today on behalf of MSDC – as its incoming President-Elect – but also as a urologist and District resident. B25-229 would provide cost-free coverage of one prostate-specific antigen test and digital rectal exam per year. It would also prohibit any health insurer from imposing a deductible, coinsurance, copayment, or other cost-sharing requirement for prostate cancer screening.
MSDC supports this legislation and urges your committee to mark-up and pass this bill as soon as possible.
Prostate cancer is the second most commonly diagnosed type of cancer among American men, after skin cancer. In fact, a man is diagnosed with prostate cancer every two minutes. Black men are 1.7 times more likely to be diagnosed with prostate cancer than white men, and 2.1 times more likely to die from prostate cancer than white men. The District has the unfortunate distinction of having the highest rate of prostate cancer deaths and is 7th among states in prostate cancer incidences.
However, we know that early detection and treatment for prostate cancer is incredibly effective in preventing death. The 5-year survival rate for prostate cancer diagnosed in its earliest stages is nearly 100% while the same rate for advanced or metastatic prostate cancer drops to 32%. This legislation would allow District men access to affordable, convenient prostate cancer screenings where they can speak with medical experts about treatment and prevention. We thank Councilmember Allen, and the eleven other co-introducers, for introducing this bill, and urge the committee to pass it as soon as possible.
Please reach out to the MSDC office if our membership can be of assistance on these or any issue. We look forward to working with you and the Committee to make the District the nation’s model for patient care.
Sincerely,
Dock Winston, MD
Director, Medical Society of DC Board