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 Issues New Requirement on Vaccines for Healthcare Workers
On Monday, DC Health announced a new requirement that all District healthcare workers must be vaccinated or be regularly tested by September 30.
The new order applies to all licensed and unlicensed health professionals (including EMS workers) who work in the District. By September 30, all healthcare workers are required to get one dose of any of the three EUA vaccines for COVID-19, or face regular testing. However, once the vaccines are granted full federal approval, the ability to opt-out with regular testing ends, and a waiver can only be granted for a religious or medical exemption.
In addition, new licensees for the District are required to show proof of full vaccination as part of an application. Renewing licensees are required to submit proof of vaccination upon renewing their license.
“It’s a very robust requirement, and it is necessary for us to ensure that we’re creating safe environments in our health-care facilities, and in any place where people receive health care . . . to make sure we can prevent outbreaks,” Dr. LaQuandra Nesbitt said, according to The Washington Post. “We all saw what happened last year during the peak of the pandemic when health-care workers themselves were succumbing to the infection because they didn’t have opportunity for protection with a vaccine.”
Keep an eye on this space for more information.
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