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 Releases Post-COVID Healthcare Report
Last weekend, the District government released a new report with "lessons learned" from the COVID pandemic.
Entitled "District of Columbia Department of Health COVID-19 Pandemic Health and Healthcare Recovery Report", the report has two halves. The first details the District's response to the pandemic and outlines how the District government acted to mitigate the impact of COVID-19 on health, the economy, and society.
The second half contains recommendations going forward, and this is the focus of the report. This section breaks into five components:
- Health Planning
- Public Health and Healthcare Workforce
- Health Information Technology
- Health Care Facilities
- Community Health Services
Each component has an analysis and listed recommendations for the Council and District government to consider. You can read the entire report here, but below are a few items of interests to the physician community:
- Explore regional licensure reciprocity to allow local healthcare professionals to more easily practice in the District
- Examine whether new licensure categories are needed to reflect new modules of care
- Explore whether "certain procedures" that "traditionally require specific oversight" should be "re-examined" for more flexible supervision options.
- Assess and potentially redefine training or supervision levels with "an emphasis of supervision truly required for safe patient care".
- Push for common telehealth scopes of practice across state lines
- Provide consumers with instruments and training for telehealth monitoring
What is not in this report?
- Resources to address healthcare provider burnout and behavioral health interventions
- Re-examining the impact of the District's medical malpractice laws and how they may harm medical care.
- Invest in local medical education and how to retain students from local medical schools and allied health schools
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