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
New Study: Women Physicians Face Major Hurdles on Pumping at Work
As if being a woman in medicine was not a struggle already, new research shows women in medicine who need to pump breast milk face especially daunting challenges.
A new study published in the Journal of General Internal Medicine looks at the difficulties facing women who pump at work. The study surveyed over 700 physician mothers via the American Medical Women's Association outreach lists and social media. All surveyed women had conceived or adopted their first child after medical school.
Survey results showed alarming statistics:
- 40% of trainees reported difficulties accessing adequate facilities or time for pumping
- 34.5% of trainees and 23.7% of attendings reported experiencing discrimination due to the need to pump
- 72% of respondents rated "protected locations for nursing/pumping breast milk" as extremely important
The authors identified four medical cultures they believe should change (see Tweet thread here):
- Creating an office culture supportive of pumping
- Setting aside protected time for pumping
- Ensuring pumping space is hygienic and near work areas
- Complying with legal requirements and ensuring financial parity
Join the MSDC Women in Medicine Section to discuss this and other realities of being a woman in medicine at our event February 3 to celebrate National Women Physician Day. Learn more and register here.
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