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 Raises Scope Creep and More with DC Board of Medicine
MSDC attended the DC Board of Medicine’s in-person open session meeting today. The meeting took place at DC Health’s new headquarters, located in Ward 8 at 2201 Shannon Pl SE, Washington, DC 20020. The meeting addressed government relations, licensure, and other physician matters. According to the current licensure census, there are currently over 13,000 physicians (MD and DO) licensed in the District of Columbia.
Topics of physician interest
- The DC scope expansion bill, or HORA, the Health Occupations Revision Act, will have its second and final vote on May 7. MSDC reiterated its strong concerns about the current iteration of the bill, which you can read about here. MSDC highlighted patient safety concerns and will continue to vigorously voice patient and physician concerns with the Board of Medicine and other stakeholders. Physicians are invited to join MSDC’s sign-on letter and to participate in MSDC’s ongoing advocacy.
- The Department of Health had its budget oversight hearings on April 11. Among the programs that will move forward is funding for professional loan repayment.
- The DC Council is considering a bill, the Firearm Injury Prevention Amendment Act, which includes a continuing education requirement for physicians and other medical professionals. MSDC is strongly opposed to all content-specific CME mandates and opposes this bill.
- Physicians are reminded that this is a license renewal year, and all DC physician licenses expire December 31, 2024. The Board of Medicine has not yet finalized the public health priority topics for this cycle. MSDC will keep members updated on CME and other requirements and will stand ready to provide individual assistance.
- MSDC discussed the Gender Equity Task Force’s compensation survey to evaluate gender pay equity among physicians in Washington, D.C. MSDC’s survey will be released in May and all physicians are encouraged to participate given the importance of diversity and equity in ensuring a sustainable workforce. Please be on the lookout so that MSDC can have a representative sample.
- The Board of Medicine has multiple vacancies for physician members. Interested members should note that the residency requirement for serving on the Board of Medicine has been modified. MSDC encourages any members who are interested to contact Robert Hay at hay@msdc.org.