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 Asks Council to Support Physicians in Underserved Areas
Today, MSDC sent a letter to the Council of DC outlining the actions it can take to ensure that all Wards have a local physician network to keep District residents healthy.
The COVID-19 public health emergency has made abundantly clear that health inequalities exist. The percentage of COVID-19 cases in the District are rising fastest in Ward 8, and 78% of COVID-19 deaths have been African-American residents. MSDC has asked the Mayor's office in recent weeks to include messaging on lifestyle choices to prevent COVID-19 mortality.
Today's letter goes in-depth to address many of the systematic issues that prevent physicians from opening offices in underserved areas. We note that the issue is not that physician do not want to practice in underserved areas like Wards 7 and 8, but rather there are structural issues that make opening a successful practice tough.
Recommendations from MSDC include:
- Providing support for physicians to buy office space in underserved areas or received reduce rent to help with overhead.
- Continue to support DC Health Care Finance efforts to help offices join the Health Information Exchange and boost reimbursement for specialists.
- Encourage affiliation agreements in new hospital contracts that allow physicians to operate independent offices but provide services to new hospitals.
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