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 Announces New Partnership with ACLM
MSDC is pleased to announce a new affiliation agreement with the American College of Lifestyle Medicine to help MSDC members find lifestyle medicine content and CME.
MSDC members can access a robust library of lifestyle medicine content through our special MSDC link:
https://portal.lifestylemedicine.org/msdc
For every physician or healthcare provider who takes a course via the MSDC portal, a portion of the fee will be made to the Healthy Physician Foundation, which will be used for physician health programs including scholarships for the ACLM conference and certification.
FAQ
What is lifestyle medicine?
Lifestyle medicine is a medical specialty that uses therapeutic lifestyle interventions as a primary modality to treat chronic conditions including, but not limited to, cardiovascular diseases, type 2 diabetes, and obesity. Lifestyle medicine certified clinicians are trained to apply evidence-based, whole-person, prescriptive lifestyle change to treat and, when used intensively, often reverse such conditions. Applying the six pillars of lifestyle medicine—a whole-food, plant-predominant eating pattern, physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connections—also provides effective prevention for these conditions.
What is ACLM and what does it do?
As the nation’s only medical professional association representing the interdisciplinary field of lifestyle medicine, the American College of Lifestyle Medicine represents a galvanized force for change; members are united in their dedication to identify and eradicate the root causes of chronic disease, with the clinical outcome goal of health restoration. ACLM closes the gap in evidence-based education in lifestyle medicine across the spectrum of pre- and post-professional training. Along with training and support of its members in their individual practices, ACLM advocates lifestyle medicine as the first and optimal whole-person treatment option for all people, mitigating much of the non-communicable, chronic disease epidemic.
Why is this important and why now?
Chronic disease is the leading cause of death and disability in the U.S. Global rates of chronic disease have never been higher, with the cost of chronic conditions eating up 90% of all healthcare dollars spent. Chronic disease is so common that 60% of U.S. adults have at least one condition, and 40% have two or more.
According to the World Health Organization, 80% of heart disease, stroke and type 2 diabetes and 40% of cancer could be prevented, primarily with improvements to diet and lifestyle.
The U.S. spends roughly 18% of its GDP ($3.35 trillion) on health expenditures. All projections point to continued global rises in chronic disease. If we don’t reverse this trend, we are headed for bankruptcy as a country. The solvency of our nation is at state.
What can be done about this?
Lifestyle medicine is an evidence-based approach shown to treat and reverse disease. It treats the underlying cause of disease rather than its symptoms that are too often addressed with ever increasing quantities of pills and procedures. Because it treats cause and not just symptoms, only through lifestyle medicine can we alter the course of spiraling health care costs.
How does lifestyle medicine differ from preventive medicine?
Primary prevention includes measures that patients can take to avoid illness, such as immunization, condom usage, regular dental cleanings and handwashing. A byproduct of having healthier a lifestyle may be disease prevention, but lifestyle medicine is primarily used for the treatment and reversal of existing, chronic disease.
Do you believe that people benefit from only vegan or vegetarian lifestyles?
ACLM believes in the adoption of a predominantly whole food, plant-based dietary lifestyle. That stance recognizes that a range of dietary practices have evidence showing healthy benefits. The common thread appears to be the intake of a large proportion of whole plant foods.