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 Declares Gun Violence a Public Health Emergency
On Wednesday, Mayor Muriel Bowser declared gun violence a public health emergency in the District and outlined steps her administration will take to reduce violent deaths.
According to DCist, the order is part of a larger initiative called Building Blocks DC. The initiative is a network of government resources and services tasked with addressing gun violence in certain parts of the District. The initiative is led by Director of Gun Violence Prevention Linda Harllee Harper.
The first step in Building Block DC is creating the Gun Violence Prevention Emergency Operations Center (EOC). Located in Anacostia, the EOC is, according to the press release, "a first-of-its-kind in the nation to deploy a public health approach to gun violence prevention."
Two advisory board with public sector representatives will guide the initiative's work. One group is co-Chaired by Dr. Roger Mitchell, who recently stepped down as the District's Chief Medical Examiner (and spoke at this year's MSDC annual meeting). The District will also create a dashboard to track the program's effectiveness, similar to the COVID-19 dashboard the District created last year.
The action comes after the District recorded 198 homicides in 2020. In 2021, the homicide rate is outpacing 2020, with a 14% increase compared to this time last year.
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