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 Resolution on COVID Vaccine Passes AMA House
An MSDC resolution on the coming COVID-19 vaccine passed the American Medical Association House of Delegates at the 2020 Special Interim Meeting.
MSDC submitted a resolution to I-20 due to concerns about the lack of trust in the coming COVID-19 vaccine. An October 2020 Lancet article cited a report showing that 31 million people follow anti-vaccine groups on Facebook, and one in six people would refuse a COVID-19 vaccine due primarily to social media misinformation. To be effective, a COVID-19 must be widely distributed and be trusted.
MSDC's recommendation (with the final title "An Urgent Initiative to Safeguard COVID-19 Vaccine Programs") urged to AMA to institute a program to take the following steps:
- Educate physicians on speaking with patients about the COVID-19 vaccine
- Educate the public on the safety of the vaccine
- Counter misinformation on the vaccine
- Form a coalition of national medical groups to create an educational campaign on the vaccine
- Support ongoing monitoring of the vaccine to ensure it is safe and effective
The resolution was considered in Reference Committee D, where Alternate Delegate Neal Barnard spoke in support of the bill on behalf of MSDC. The committee accepted most of the recommendation and made wording changes to clarify language intent.
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