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 Hosts First Unconscious Bias Task Force Meeting
On Wednesday evening, MSDC convened its first meeting of its Unconscious Bias Task Force. The task force was created by the MSDC Board late last year to examine the issue of unconscious bias in medicine in the District, determine what impacts it has on healthcare delivery, and make recommendations to address the issue for the physician community.
In light of the COVID-19 public health emergency, the task force had a condensed meeting via Zoom. Chair Matthew Lecuyer, MD, of Children's National Hospital, thanked the participants and outlined his vision for the task force.
Among the items decided at this initial meeting:
- The task force would create a white paper on the topic based on research, interviews, and discussions. The white paper would be released in early December with a draft available to share at the MSDC annual meeting.
- Three key areas that will be consulted are undergraduate medical education, graduate medical education, and patient perspective.
- The task force will seek to acquire survey data from different segments to guide their discussions.
The next meeting of the task force will be the week of April 6, with the exact date to be determined. Anyone interested in participating in the task force is encouraged to contact MSDC staff to learn more. The task force roster is below.
- Tamika Augste, MD; Chair OBGYB Clinical Practice Council, MedStar
- Kim Bullock, MD, FAAP; Chair, MSDC Task Force on Family Violence
- Laurie Duncan, MBBS, FACP, MS; Member, MSDC Executive Committee and MSDC Physician Health Program
- Isela Melendez-Carpio, M.Ed., Georgetown University School of Medicine
- Alicia Khan; Medical Student
- Marjorie Williams, MD
- J. Desiree Pineda, MD, FACP; President, MSDC (ex officio)
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