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 Endorsed CPR Bill Passes Council
At its October 15 legislative meeting, the DC Council passed legislation endorsed by MSDC to save lives and protect children from sudden health emergencies.
B25-570, the Cardiac Planning and Response (CPR) Amendment Act amends the Public Access to Automated External Defibrillator Act of 2000 to define the term cardiac emergency response plan and require schools to establish cardiac emergency response plans. MSDC joined a diverse coalition of public health organizations to promote the bill, which we expect will make it easier to respond quickly when someone has a cardiac emergency at school or on an athletic field.
Below is the testimony Dr. Ashesh Patel, MSDC President, delivered at the bill's hearing this summer.
February 8, 2024
Chair Phil Mendelson Councilmember Christina Henderson
Chair of the DC Council Chair, Committee on Health
1350 Pennsylvania Ave NW 1350 Pennsylvania Ave NW
Washington, DC 20004 Washington, DC 20004
Dear Chair Mendelson and Chair Henderson,
The Medical Society of the District of Columbia (MSDC) is the largest medical organization representing metropolitan Washington physicians in the District. We advocate on behalf of all 11,000 plus licensed physicians in the District and seek to make the District the nation’s model for patient care and physician practice.
I am testifying today in favor of B25-570, the Cardiac Planning and Response (CPR) Amendment Act. MSDC is a strong believer in public health and access to timely care, and little can save a life more than training and resources in an emergency. According to the Centers for Disease Control and Prevention, roughly 2,000 people under the age of 25 die annually from sudden cardiac arrest. We have seen devastating examples of people who are physically fit felled by sudden cardiac arrest and in many cases, it is prior planning and access to equipment that save a person.
DC law already requires AED placement in every school and requires coach, trainer, and nurse training on how to use it, as well as requiring high schools to provide AED and CPR training. This bill goes beyond that to include best practice with minimal disruption by:
• Requiring schools to develop evidence-based cardiac emergency response plans (CERPs)
• Requiring schools with athletic programs to develop a plan for their athletic fields for games and practice
Why is a CERP important? It is a written document that establishes the specific steps to reduce death from cardiac arrest in any setting. While this may sound like an onerous requirement for schools and athletic departments, it is not. The American Heart Association and other health organizations have templates and resources to help schools “plug and play” a plan.
Please reach out to the MSDC office if our membership can be of assistance on these or any issue. We look forward to working with you and the Committee to make DC the nation’s model for patient care and physician practice.
Sincerely,
Ashesh D. Patel, MD FACP
President, Medical Society of DC