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
Physician Community Speaks Loudly on Scope Bill
The DC physician community spoke up and spoke loudly on December 7, arguing against expanding scope of practice in DC.
The cause was a hearing in the Committee on Health for B25-545, the HORA Revisions Act. The bill would update the law governing medical licensing and practice in the District. Notably, the bill would dramatically expand the scope of practice for numerous allied health providers as well as change the Board of Medicine to include physician assistants, a podiatrist, a chiropractor, and an acupuncturist.
MSDC President Dr. Ashesh Patel testified early in the hearing on behalf of the Society. In his testimony, he noted the large number of physicians and organizations speaking or submitting testimony concerned with the legislation. He shared that MSDC's testimony would briefly touch on these topics, and leave the details to others, while highlighting larger concerning themes. Other members, like Dr. John Dombrowski, spoke to specific concerns on scope expansion. Even the American Medical Association testified at the hearing to give a national perspective.