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 Board of Medicine Recommends Best Practice License Language
At the January 28, 2026 meeting, the DC Board of Medicine recommended a change to a license question designed to identify physicians undergoing treatment. The recommended question reads as follows:
"Do you have a condition that currently impairs your judgement or adversely affects your ability to practice medicine in a competent, ethical, and professional manner? (Yes/No)"
DC is one of 10 states that the American Medical Association and Dr. Lorna Breen Heroes Foundation had identified as not having recommended language on its license application. As the Dr. Lorna Breen Foundation says on its website:"Like everyone, health workers deserve the right to pursue mental health care without fear of losing their job. However, overly invasive mental health questions in licensing and credentialing applications prevent health workers from seeking support and increase the risk of suicide.
Such questioning tends to be broad or stigmatizing, such as asking about past mental health care and treatment, which has no bearing on a health worker’s ability to provide care and violates the Americans with Disabilities Act.
Ensuring that health workers can access mental health care when needed not only benefits their wellbeing, but it also improves the health of our entire country."
The next step is for DC Health HRLA (Health Regulations and Licensing Administration) staff to review the recommendation and approve the change. MSDC will follow up with recommended action for members.This is a big win for physicians and physician health, and MSDC thanks the Board of Medicine for taking this step.
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