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 Board of Directors Discusses Equitable Pay in Medicine, Unconscious Bias
The MSDC Board of Directors held wide-ranging discussing on major equity issues in medicine at its first Board meeting of 2021.
The Board welcomed new member Matthew Lecuyer, MD, an emergency pediatric medicine physician at Children's National Hospital. Dr. Lecuyer is an alternate delegate for the MSDC American Medical Association delegation and join EW Emanuel, MD as one of MSDC's two new alternates.
The Board heard a presentation by the American Medical Women's Association on "Addressing Gender Based Pay Disparities in the Medical Community". DC native Medha Reddy, a first year medical student and AMWA volunteer, discussed how MSDC could be involved in the movement for equitable pay in the medical community. The Board engaged in the discussion and asked Ms. Reddy to work with the Women in Medicine Section to plan next steps and recommendations on this ask.
The Board also heard updates on two of its major initiatives. Unconscious Bias in DC Medicine Task Force Chair Dr. Lecuyer shared the executive summary of the Task Force's paper and walked through high-level analysis of their data [n.b. receive a summary at the March 10 webinar on the task force's work]. Dr. Emanuel also shared analysis of the Membership Task Force's survey data and implications for a potential new membership model.
The Board also took the following actions, among others:
- Renamed the PLAN Committee as the Advocacy Committee
- Adopted the Investment Policy Statement for 2021
- Approved the Awards Committee's recommendation for 2020 MSDC award winners
- Approved the creation of an Industry Committee
The next MSDC Board meeting is April 19, 2021.
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