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
Mayor's Task Force Recommends Streamlined Licensing, Prior Auth Reform
Mayor Muriel Bowser's task force to sustain the healthcare workforce released its recommendations officially, a few of which mirrored MSDC's own priorities.
This report - seen here - will help set budget and action priorities for the health agencies in the years to come. MSDC served on the task force, as did some of its members.
The recommendations from the task force include:
- Expand data infrastructure to improve health professional license processing, allow for interoperability with third-party data providers and other jurisdiction licensing agencies, and improve data collection to support healthcare workforce development planning.
- Accelerate coordinated health professional licensure across the District, Maryland, and Virginia through compacts and policy coordination, technology interoperability, expanded use of temporary licensure, and adoption of endorsement pathways for all comparable licenses, registrations, or certifications.
- Allow for certain non-District residents to be considered for health professional licensing board membership.
- Reduce systemic factors contributing to healthcare workforce burnout, by reducing documentation burden, insurance prior authorization requirements for routine care, and improving healthcare workforce quality of life.
The second and third recommendations above are already being implemented by DC Health, and MSDC is working to implement all four. MSDC thanks its advisory committee who helped craft MSDC's comments to the task force and MSDC members who participated in the task force.