MSDC Mourns the Passing of Past President Dr. John Niles

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.

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 Mourns the Passing of Past President Dr. John Niles

Oct 9, 2026, 08:40 by MSDC Staff

Dr. Niles served as MSDC President in 1990 but more importantly was a voice for strong physician practices.

MSDC joins the entire medical community in the passing of Dr. John Niles. A celebration of his life will take place tomorrow at Howard University's College of Medicine.

Dr. Niles served as MSDC President in 1990. His tenure was marked by a passionate advocacy for private practice, medical malpractice reform, and women's health. For years, Dr. Niles was a frequent speaker and testifier before the District government warning of the collapse of private practice - especially in Ward 8 - and its impact on care for all residents, but especially the less fortunate. He was a child of the District, graduating from Spingarn High School and serving as the first Black chief of staff for Columbia Hospital for Women.

"Dr. Niles' passing is a huge loss to our community," said MSDC President Dr. Klint Peebles. "Looking back on his statements and letters, he was a prophetic voice warning DC that failure to revise its malpractice laws and support physician practices would lead to many of the health disparities we continue to see today. He was a pioneer and his spirit of being unafraid to speak the truth should be an inspiration to all physicians."