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
CDC Confirms Underlying Medical Conditions Heighten COVID-19 Risks
New data from the Centers for Disease Control (CDC) confirm that patients with underlying medical conditions like heart disease or diabetes face an elevated risk of complications from COVID-19.
The report confirms that MSDC's push for local and federal officials to include messaging on health management in COVID-19 announcements was accurate.
The report analyzed data from the over 1.7 million people infected with COVID-19 between January 22 and May 30. Because ethnic and racial demographic was not comprehensively collectedly over that time period, only about 600,000 people had race and ethnicity information and thus the CDC could not provide complete ethnic or racial breakdowns for underlying conditions. However, the data could show that ethnic minorities were over represented in the ill population:
- 33% of patients were Hispanic (18% of population overall)
- 22% were black (13% of the population)
- 1.3% were Native American (0.7% of the population)
Overall, individuals with underlying medical conditions were hospitalized six times as often as healthy individuals and died 12 times as often. The most common underlying conditions in people infected with COVID-19 were heart disease (32%), diabetes (30%) and chronic lung disease (18%).
You can read the entire report here.
MSDC has long advocated that public health messages should include messaging about managing or preventing underlying health conditions. In its letter to the Mayor, MSDC urged the District to promote smoking cessation, up-to-date prescriptions, and improved diet.
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