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
Protecting DC Physicians and Patients: MSDC’s September Board Meeting Highlights
On September 15, 2025, the MSDC Board of Directors convened virtually to advance its strategic goals and reinforce its commitment to protecting physicians and patients in the District of Columbia. The meeting was held via Zoom due to renovations at MSDC's office building.
Key Highlights:
Strengthening Vaccine Policy for Public Health
The Board unanimously approved a comprehensive update to the Society's immunization policy (see below), emphasizing universal access to CDC/ACIP-recommended vaccines. The new policy also supports equitable distribution, transparent reporting, and alignment with the American Academy of Pediatrics’ immunization schedule for children in schools and childcare settings. This move underscores MSDC’s dedication to evidence-based public health measures that reduce disparities and protect vulnerable populations.
440.012: Immunization Policy. MSDC affirms that immunizations are among the safest and most cost-effective public health interventions, preventing disease, disability, and death. MSDC supports universal access to CDC/ACIP-recommended vaccines without cost-sharing and through equitable, culturally responsive distribution across all populations. MSDC is committed to advancing evidence-based vaccine policy that protects all District residents and reduces health disparities, advocating for District regulations and public health funding that strengthen vaccine supply chains and enable transparent reporting of immunization coverage rates across the District.
Pediatric Vaccines: MSDC supports the American Academy of Pediatrics’ recommended immunization schedule as a requirement for all District children attending childcare or school, with exemptions only for specific medical contraindications.
Federal Policy Task Force Data
To better understand and respond to federal actions affecting DC healthcare, the Board expanded the Task Force’s responsibilities. It will now oversee an initiative to track the impact of federal policy changes on the DC healthcare landscape and use this feedback to craft its recommendations in 2026.Collaboration with DC Health Benefit Exchange
Executive Director Mila Kofman presented updates on the Exchange and Healthy DC initiative, which will provide health coverage to individuals and families formerly covered by Medicaid.The next MSDC Board meeting will be December 8.
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