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 Member Profile: Dr. Ashlee Williams
1. Why do you belong to MSDC? What made you join, and what keeps you engaged?
I joined the Medical Society of DC because I believe physicians are stronger when we show up for one another. Early in my career, I realized how important it is to have a community of colleagues outside of your own practice setting — people who understand the challenges of medicine and are equally committed to improving care in our city. MSDC brings together physicians from across specialties and systems who care deeply about the health of Washington, DC. What keeps me engaged is the opportunity to connect with thoughtful leaders, learn from colleagues, and help support the next generation of physicians practicing in our community.
2. If you could have dinner with any historical figure (medical or otherwise), who would it be and what would you ask them?
I would choose Dr. Rebecca Lee Crumpler, the first Black woman physician in the United States. She practiced medicine in the 1800s and cared for newly freed slaves after the Civil War — a time when both her patients and she herself faced enormous barriers. I would love to ask her how she stayed resilient and what kept her grounded in her purpose. I imagine her answer would be a powerful reminder for physicians today about the importance of compassion, perseverance, and showing up for our patients even during challenging times.
3. What's one piece of advice you'd give to a physician just starting their practice in the DC area?
Take the time to build relationships with other physicians and become part of the broader medical community. Washington, DC has an incredibly collaborative and diverse physician network, and those relationships make a real difference — whether you need clinical advice, mentorship, or simply support during a difficult week. Medicine is a team sport, and the connections you build early in your career will sustain you throughout your career.
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