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 President Asks DC Health to Reduce Fees, Remove Stigmatizing Questions
MSDC President Dock Winston, MD, MPH, MBA testified on March 5 at a DC Council Committee on Health hearing reviewing the performance of the DC Health boards of licensure.
At the hearing, Dr. Winston brought up two issues of concern to the membership - license renewal fees especially for one-year license renewals, and ensuring DC meets the AMA/Dr. Lorna Breen Foundation's best language on physician wellbeing.
Below is Dr. Winston's testimony.
March 5, 2025
Councilmember Christina Henderson
Chair, Committee on Health
1350 Pennsylvania Ave NW
Washington, DC 20004
Dear 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 appreciate the opportunity to testify today on behalf of the Society and speak on our work with the Board of Medicine over the past year. MSDC appreciates the leadership of Dr. Chithenga and the entire staff of the Board of Medicine. Last year we worked together to provide information on medical license renewal and worked closely together to help physician renew their medical license.
For today’s hearing I want to highlight three issues for the committee:
1. Licensing fees for one-year renewals: The Board implemented a new renewal cycle beginning last year where a medical license is renewed based on the applicant’s birth month and year. MSDC supports this idea BUT does not support that DC Health charged the same fee for licensees who renewed for one or two years. We strongly believe that licensees who have to renew this year should be exempt from a licensee renewal fee or at a minimum receive a greatly reduced fee. Asking physicians to pay a fee for four years but only renewing essentially for three is problematic.
2. Change harmful language around wellness and addiction. The Mayor’s Healthcare Workforce Task Force included a recommendation in its draft report to limit, “‘fitness for duty’ questions during application and renewal cycles” such that they only apply to current impairment to practice safely. The Dr. Lorna Breen Heroes Foundation has identified the District as one of the states whose licensure language can harm physician wellness by forcing unnecessary disclosure of past impairment and wellness treatment. We want to continue speaking with the Council and DC Health about removing any license or certificate language that would stigmatize physicians seeking wellbeing care.
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 the District the nation’s model for patient care and physician practice.
Sincerely,
Dock G. Winston, MD, MPH, MBA
President, Medical Society of DC
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