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
Elizabeth Ghandakly Aims High, and Hits Her Mark
During high school in Ohio, Elizabeth Ghandakly gravitated towards public policy and participated in her school debate team and mock trials. This set her on trajectory for a career in law, which she pursued during her studies and earned both her undergraduate degree and juris doctorate from Ohio State University and the school’s Moritz College of Law, respectively.
“During my years in law, I represented large corporations on contract negotiations. I enjoyed the experiences I had while practicing, but during those years, I was drawn to medicine,” she admits.
Becoming a successful, practicing lawyer would be a huge accomplishment for many people, but for Ghandakly, she felt a little out of place. With both feet firmly planted in law, she kept one toe in the medical world, “I volunteered at Children’s Hospital and read medical journals and articles.”
In 2009, Ghandakly took a leap of faith and decided to change careers and become a physician. Accustomed to their daughter’s spirit and trusting that she considered the risks associated with this monumental decision before informing them, Ghandakly’s parents were supportive. “They were a little uncertain but trusted that I knew what I was doing. I was also fortunate to work in a field that would support my return to school for medicine,” said Ghandakly.
She informed her employers, who were equally excited and supportive about her decision.
Ghandakly worked in law and returned to the classroom for evening classes at the University of Maryland until 2018 when she began medical school. She then worked part time for a year and a half until leaving law. “The University of Maryland offers evening classes for people looking to switch careers. These courses enabled me to satisfy all the prerequisites I needed to earn a medical degree,” she said. She credits her sharp scheduling skills for helping her stay on track during these busy years. The most challenging part of her return to school was getting back into the grove of homework.
The course load was a test of her commitment to the switch. “I knew I was in the right place when I could focus on lab work after a full day of law work. I maintained my interest in medicine as I moved through the coursework,” said Ghandakly.
Today, Ghandakly is a fourth-year medical student at George Washington University School of Medicine & Health Sciences eagerly awaiting The Match on March 18. After submitting applications to residency programs, on this day, she will learn which program she was accepted to. It is essentially the NFL Draft of medicine. Ghandakly hopes to remain in the district for her residency.
Regardless of her specialty, Ghandakly wants to remain in policy, specifically healthcare policy. “My law degree has prepared me to impact health policy and being in D.C. puts me in proximity to all the lawmakers who can implement change.”
Ghandakly joined the Medical Society of D.C. at the end of her first year of medical school in 2019. Her involvement with MSDC has helped her to connect with others in her community and new career field. “I joined to be a part of advocacy efforts and general policy change,” she said. Since joining she provided written and oral testimony on behalf of MSDC to the D.C. Council Committee on Health Hearing in support of the Minor Consent for Vaccination Bill (B23-0171), June 2019.
Working fulltime in law and pursing a medical degree in the evenings has its overwhelming moments, but Ghandakly finds time to relax with friends and outdoor activities. “I enjoy camping, tennis, and started running again during COVID.” Ghandakly ran her first marathon, the New York City Marathon, in 2018. Her hiking escapades have taken her to Old Rag Mountain, Bearfence Mountain, Humpback Rocks, and Billy Goat Trail just to name a few.
Ghandakly even took a leap of faith of a different kind when she leapt from an airplane with friends skydiving.
While Ghandakly enjoys adventuring, risk-taking perhaps more than other people, and is training for the fall Marine Corps Marathon, sometimes she just wants a quiet, simple evening, playing board games with her friends and spending time with her dogs.
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