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 To Offer Vaccines to Residents With Pre-Existing Conditions In March
Today Mayor Muriel Bowser announced that the District would expand vaccine appointments to Phase 1C, Tier 1 residents, or those with pre-existing conditions, the week of March 1.
During today's press conference, the Mayor announced the District moved to the next phase of eligible populations. That group includes grocery store workers, social service outreach workers, manufacturing workers, and food packaging workers.
Even though DC estimates it will not have enough vaccine doses to meet demand, DC Health still estimates 70% of residents 65 and older will have a vaccine by the end of the month. Despite this progress, the District announced a few changes to the appointment process:
- Thursday appointments will open at 6 PM tomorrow, and the Thursday appointments will alternate opening between 9 AM and 6 PM openings every week.
- In March, DC's system will be able to give residents who pre-register a 24 hour notice window to sign up for appointments.
The Mayor also announced that beginning in March residents with pre-existing conditions are eligible to be vaccinated. Twenty different "conditions" make a resident age 16-64 eligible, including pregnancy and cancer. DC estimates 160,000 residents have at least one of these conditions, although that list would include people already eligible like healthcare workers.
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