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
Mayor Extends Stay At Home Order Through June 8
Yesterday, District Mayor Muriel Bowser issued a new order extending the District's public health emergency through June 8.
The order also includes an extension of the "stay-at-home" order for residents except for exempt purposes. The mayor's order did permit certain stores and markets to apply for a waiver to operate during the public health emergency.
The order also requires all individuals to wear a face covering or mask if engaged in essential business or minimum basic operations if other people are present, or if social distance cannot be maintained. Face coverings would not be required for children under 9 (although those over 2 are encouraged to wear a mask), during recreational activities if social distance cannot be maintained, or those with a disability preventing wearing a mask.
Physician offices, medical appointments, and seeking treatment for medical care continue to be essential business, allowing physician practices to remain open if possible.
The mayor again outlined the four criteria her administration is seeking to gauge when to begin winding down the public health emergency:
- 14-day sustained decrease in community spread
Transmission rate of fewer than 1.0 for three days
- Testing Capacity
Ability to test the following groups: symptomatic, at-risk health care workers, essential workers, and close contacts of all new positive cases
- Health Care System Capacity
Less than 80% health care capacity (without medical surge) over seven-day period
- Public Health System Capacity
Contact tracing attempt of new cases within one day, and contact tracing attempt of their close contacts within two days
“The continued sacrifices by residents and businesses are saving lives and helping us get to the other side of this incredibly difficult time for our city,” said Mayor Bowser. “Together, by staying home a little longer, soon we will be able to reopen DC safely and sustainably.”
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