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 Statement on Post Story on Immoral Stealing of Human Remains
Below is a statement from MSDC President Dr. Ashesh Patel on information shared in today's Washington Post story, "Smithsonian Targeted DC's Vulnerable to Build Brain Collection".
There are too many examples of physicians in the past, even highly respected ones, who in the pursuit of scientific knowledge, engaged in morally impermissible behavior. This was not only a failing of the individual physician but also of the healthcare system in which they practiced.
The combination of the inappropriate acquisition of human remains and their use to support racist theories make the Washington Post’s report disturbing. Sadly, this was not the first time and will not be the last time that physicians will fail patients, even those entrusted with leadership in the profession.
Recognizing this, the Medical Society of DC (MSDC) strives every day to ensure that the practice of medicine in DC is, as our vision says, the nation’s model for patient care and physician practice. We work with all stakeholders to inform DC physicians about best practices. In particular, we partner with DC government and local private stakeholders to do so.
In 2023, even before we were made aware of the Washington Post’s report, MSDC released its Diversity, Equity, Inclusion, and Belonging (DEIB) statement as the next step in its work to address medicine’s failings. This is a continuous process we will use to live up to the high standards that medicine can and should be held to.
We also adhere to the American Medical Association’s policy H370-998: Organ Donation and Honoring Organ Donor Wishes. MSDC affirms the importance of organ and tissue donation to a healthy society but strongly believes that donations must be done within the ethical guidelines outlined by organized medicine.
We mourn the mistakes of the past and affirm the need to learn from them to ensure that they are not repeated.
Policy H370-998: Organ Donation and Honoring Organ Donor Wishes
We the AMA (1) continues to urge the citizenry to sign donor cards and supports continued efforts to educate the public on the desirability of, and the need for, organ donations, as well as the importance of discussing personal wishes regarding organ donation with appropriate family members; and (2) when a good faith effort has been made to contact the family, actively encourage Organ Procurement Organizations and physicians to adhere to provisions of the Uniform Anatomical Gift Act which allows for the procurement of organs when the family is absent and there is a signed organ donor card or advanced directive stating the decedent's desire to donate the organs.
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