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
DC represents well at AMA I-25
The MSDC American Medical Association delegation and "friends" were everywhere at the House of Delegates 2025 Interim meeting (I-25) this weekend at National Harbor. While this is not unusual - DC has always been an outsized player in HOD policy - this year's meeting saw DC people even more present with the meeting so close to home.
The DC delegation introduced one resolution and backstopped another that became AMA policy. Resolution 901 would align AMA policy with more precise science by differentiating between different types of ultra-processed foods. Generally the media and public assume all ultra-processed foods are bad for health, but there are some vegan and non-diary alternatives that fall into this definition. The resolution makes sure that soymilk is not treated the same as hot dogs in dietary guidelines. The second resolution establishes policy on fire risk standards for civilian and non-industrial clothing. The resolution points out the recent tragedies in New York and DC of people being lit on fire, and how fire-retardant clothing could have helped save their lives.
The meeting was not just resolutions, however. DC represented across the meeting in various events, including the DC/MedChi Maryland collaborations, Southeastern Delegation meetings, and the Organization of State Medical Association Presidents (OSMAP). Two of our Board members (Dr. Tu on CSAPH and Dr. Knight of CEJA) served on important committees for the meeting. Various other DC physicians attended coalition and section meetings.
The next AMA HOD meeting is in Chicago June 5-10, 2026.
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