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 Joins AMA, AAP DC on Amicus Supporting Minor Consent for Vaccines Law
On Friday, a coalition of health and advocacy organizations filed an amicus brief in a case challenging the District's new law permitting minors in some cases to consent to vaccinations.
The case, Mazur v. District of Columbia Department of Health, challenges the applicability of the Minor Consent for Vaccinations Amendment Act of 2020. This law - which was supported by MSDC - permits physicians to vaccinate minors over the age of 11 without parental consent if the minor displays an understanding of the vaccine, and the vaccine is on the ACIP schedule for the minor. The plaintiff sued the District alleging his minor daughter sought a vaccine without his consent at a DC medical facility, and this conflicts with the National Childhood Vaccine Injury Act of 1986.
The law has a number of safeguards built in to protect the minor from what is essentially one of the safest medical procedures available. MSDC supported this legislation because there are multiple reasons a minor may seek vaccination without a parent present - the parent may not be able to take the minor to an appointment, the minor may be homeless without parental involvement, or the parent may have an illogical opposition to vaccines. The law creates a process where the minor can still be vaccinated if they are aware of the vaccine, possible side effects, and health implications.
MSDC supported this legislation and celebrated its passage because it allows minors to be vaccinated without an undue burden on the patient or physician. MSDC joins the American Medical Association, American Academy of Pediatrics (AAP), AAP DC chapter, and the Society for Adolescent Health and Medicine. The brief was written by the Democracy Forward Foundation.
You can see the brief here. You can also see the press release announcing the brief here.
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