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 Gender Equity Task Force Launches DC Physician Compensation Survey
MSDC’s physician-led Gender Equity Task Force has launched a comprehensive, widespread study of physician compensation as it relates to gender pay parity in the District of Columbia.
Gender pay disparity and its negative impacts are well-documented on a national level, but reliable data on the District of Columbia is lacking. The confidential survey, which can be found here, is open to all physicians in the metropolitan Washington area.
“This survey is a much-needed and comprehensive survey of physician compensation in the District and will assist in gaining a better understanding of gender-based pay equity, or lack thereof, in the District,” said Dr. Monika Masanam, Co-chair of the Gender Equity Task Force. “The lack of reliable data for such a diverse physician community as we have in the District of Columbia is unfortunate. Inequity in all its forms is unsustainable and destructive to the physician workforce and healthcare as a whole. With this important, timely study, MSDC reinforces its commitment to diversity, equity, inclusion, and belonging.”
The survey was carefully developed by the Task Force to ensure confidentiality given the nature of the sensitive information being gathered. The survey is open to physicians of all gender identities. The survey will evaluate specialty, tenure, and practice type. It also considers compensation in its entirety including not just base salary, but compensation structure, benefits package, workload, supplemental income, and more.
Since its inception in 2022, MSDC’s Gender Equity Task Force has studied the national gender pay gap and found clear national and regional trends:
- Nationally, male physicians earn more than their female counterparts. Recent studies put the pay gap between 23% and 29%. A Maryland study found a gap as high as 50%.
- Over a lifetime, these disparities can add up to a sizeable difference of $2 million less.
- Additional nationwide data on compensation inequality is available at http://www.msdc.org/genderequity.
In addition to launching the survey, this year the GE Task Force also initiated a mentorship program and held a program on contract negotiations, with plans to do more. As women comprise a growing share of the physician workforce, the Task Force’s work greatly impacts the DC physician workforce and healthcare landscape. Learn more about this important work and how you can participate.