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
Board of Medicine January Meeting Provides Regional Licensure Update
MSDC attended the DC Board of Medicine’s monthly meeting today to reiterate its support for regional licensure reciprocity. The DC, Maryland and Virginia medical boards will meet over the next week to discuss process and next steps. Regular MSDC readers will recall that the Board of Medicine voted to move forward with regional reciprocity at its December meeting. With prodding from MSDC, Virginia and Maryland are moving towards greater interstate licensure coordination with the District.
The Board of Medicine indicated that it still has vacancies for physician and consumer members. If you are interested in applying or have questions regarding requirements, contact hay@msdc.org.
The Executive Director also provided the census report for DC Board of Medicine licensees. There are currently 11,844 physicians (MD, DO) licensed in the District. Below are the complete census figures.
MEDICINE AND SURGERY 11,302
OSTEOPATHY AND SURGERY 542
ACUPUNCTURIST 160
ANESTHESIOLOGIST ASSISTANT 106
MEDICAL TRAINING LICENSE I(A) 1,187
MEDICAL TRAINING LICENSE I(B) 325
MEDICAL TRAINING LICENSE II 22
MEDICAL TRAINING REGISTRANT 957
NATUROPATH PHYSICIAN 63
PHYSICIAN ASSISTANT 1,020
POLYSOMNOGRAPHIC TECHNICIAN 2
POLYSOMNOGRAPHIC TECHNOLOGIST 60
POLYSOMNOGRAPHIC TRAINEE 2
SURGICAL ASSISTANT 112
CHINESE HERBOLOGY 4
TOTAL 15,864
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