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
How ACEs Impact You, Your Patients, and the Health System
Adverse Childhood Experiences (ACEs) have a significant impact on health, especially in the District of Columbia, where 12.8% of children 17 or younger are impacted, according to the National Survey of Children’s Health. These traumatic experiences have devastating effects that impact health and wellbeing not just in childhood but well into adulthood. In fact, the CDC states that at least 5 of the top 10 leading causes of death are associated with ACEs.
Given the long-lasting developmental repercussions of ACEs, MSDC’s Task Force on Family Violence has encouraged physicians of all specialties to better understand ACEs and the impact across the health care spectrum. To assist, members of the Task Force developed a series on ACEs in the District of Columbia in two parts:
- Part 1: What Every Physician Needs to Know About Trauma-Informed Care: A microlevel look at ACEs, focusing on the patient-physician relationship and how trauma-informed care can improve patient outcomes for all specialties.
- Part 2: ACEs In Washington, DC – A Macro Perspective: A macrolevel look at ACEs includes policy implications and patient advocacy, with considerations for the District.
Further resources can be found below.
- Health Education About and Advocacy Against Violence and Abuse Across the Lifespan – a global health summit taking place September 12-13, 2024, in Washington, DC.
- Period of Purple Crying – a resource to support prevention of abusive head trauma
- Stewards of Children – a resource on child sexual abuse
- Balancing ACES with HOPE - a report on positive childhood experiences
- SEEK (Safe Environment for Every Kid) – a resource for wellbeing
If this issue is of interest to you, get involved in MSDC’s Task Force on Family Violence here. The Task Force is open to MSDC members and contributes to policy initiatives covering victim's services, critical health care problems, and educational outreach across the city.
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