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
What to Know About the DC Scope of Practice Expansion Bill
The Medical Society of the District of Columbia (MSDC) is the leading voice for physicians in Washington, DC, committed to uniting physicians to advocate for physician-led health care in Washington, DC that protects patients from harm and increases access to quality care. MSDC is leading a coalition of Washington, DC specialty medical societies to advocate against the Health Occupations Revisions General Amendment Act of 2023.
MSDC has long advocated that a physician is the most qualified professional at the head of a care team. Physicians have the most health education and pre-practice experience of any health professional, and thus must be involved in all but the most mundane health care decisions. Allied health professionals are a valuable part of the care team, but their medical education and experience limits their role.
Specifically, we are asking for the following changes to the proposed bill:
- Do not expand the type of health care professionals allowed to prescribe narcotics in light of the ongoing opioid crisis in the District.
- Do not allow podiatrists to apply anesthesia.
- Do not allow pharmacists to order and interpret lab testing without physician supervision because they do not have the proper training to do so independently.
- Do not allow allied health professionals to administer anesthesia without physician supervision since only physicians have the proper amount of training to do so independently.
- Do not allow athletic trainers to “practice medicine” beyond administering first aid.
- Do not expand chiropractic care to include “primary medical care” currently reserved for physicians because they lack the proper training to do so independently.
- Do not allow physical therapists to order radiologic imaging without physician supervision because they lack the proper training to do so independently.
- Do not remove the current restrictions on scope of practice for allied health nurses because their level of training does not match that of physicians.
What are the next steps with the bill?
The DC Council will consider the bill in May.
What can I do about the bill?
We urge physicians licensed in Washington, DC to contact the Mayor’s Office and DC Council to express any concerns they may have on the proposed expansion to scope of practice for allied health professionals in the bill as a misguided risk to their health.
Click here to send an individual letter today.
Visit our coalition page to learn more.
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