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
Council Debates Healthcare Licenses, MCOs, and Vaccine Mandates
Meeting formally for the first time since passing the budget, the DC Council debated a number of healthcare bills of interest to the physician community.
Of primary interest is the "Preserve Our Healthcare Workers" temporary and emergency bills introduced by Councilmember Vincent Gray. The bills extend the temporary license language in place from DC Health for the maximum time allowed by emergency and temporary bills. It also requires any healthcare practitioner using a "temporary license" to be fully vaccinated (as defined by DC Health). The bill is important to the District healthcare community because it allows health facilities to maintain needed staffing levels while healthcare licenses are approved. In addition, practitioners in Maryland and Virginia who are awaiting license approval while treating DC patients can continue to treat their patients.
In addition, the Council discussed legislation extending the three current managed care organization contracts for an additional nine months. This action allows the three previously approved MCOs to continue covering Medicaid beneficiaries until the new rebid process is complete. MSDC and other healthcare associations sent a letter to the Mayor and Council asking them to work together on the MCO contracting issues that could have deprived DC residents of care during this COVID Delta surge. The hope is this compromise will indeed preserve beneficiaries' access to care.
The Council also addressed other healthcare topics, including:
- Requiring the Council itself and staff to be vaccinated against COVID-19
- How students can opt into virtual learning due to risk from COVID-19
Physicians interested in learning more or becoming involved in advocacy are welcome to share their interests with MSDC here or calling 202-466-1800.
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