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
DC Insurers File Proposed Rates for 2021 Health Plans
On Wednesday, the Department of Insurance, Securities and Banking (DISB) announced it has received proposed health insurance plan rates for the four mayor payers in advance of the 2021 open enrollment period for DC Health Link.
According to the press release, DISB received proposals from Aetna, CareFirst, Kaiser Permanente, and United Healthcare. Overall, 188 plans were filed, an increase of seven from last year. The number of small group plans increased from 156 to 163 but the number of individual plans remained static at 25.
You can see the proposed rates here.
Per the press release:
In the individual market, CareFirst proposed an average increase of 14.7 percent for HMO plans and an average decrease of 0.6 percent for PPO plans. Kaiser proposed an average decrease of 2.0 percent. For small group plans, CareFirst filed average rate increases of 1.1 percent for HMO plans and an average decrease of 1.6 percent for the PPO plans. Kaiser small group rates proposed, on average, no change from the prior year. Aetna filed for an average increase of 7.4 percent for HMO plans and 38.0 percent for PPO plans. Finally, United proposed an average increase of 17.4 percent and 10.3 percent for its two HMOs and 11.4 percent for its PPO plans.
“In keeping with the Bowser Administrations efforts to support residents and small business owners, it is the Department’s duty to ensure that rates are fair and adhere to District law,” said DISB Acting Commissioner Karima Woods. “The rate review process allows us to work with our insurance companies to evaluate their proposals so that the District's insurance rates are adequate and not excessive or unfairly discriminatory.”
The proposed rates are now open for public comment; those wishing to comment on the rate changes may do so by emailing HealthRate.Comments@dc.gov.
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