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
MSDC Board Votes to Create Gender Equity Task Force
The MSDC Board of Directors held its first meeting of 2022 on February 28, and the agenda was packed. Similar to the two previous meetings, Board members gathered in-person at MSDC's offices as well as online.
The agenda included a new proposal to create a gender equity task force, which the Board approved. This task force will issue a report, "detailing its positions on gender equity in medicine and provide tangible recommendations on how MSDC can further promote the advancement of this cause in medicine including, but not limited to, suggestions for programming, initiatives, and resources for members and the medical community at large." The task force will also create a reporting system to track the demographics and equitable representation among MSDC volunteers, speakers, and event attendees. The recommendations came from the Chairs of the Women in Medicine Section and Advocacy Committee as a follow-up to a presentation from the American Women's Medical Association last year.
The Board also approved a new policy on healthy foods in DC healthcare facilities, including hospitals. Recognizing that changes in public health can best be modeled when patients receive care, the new MSDC policy encourages all healthcare facilities to offer healthier food alternatives, stop serving processed meat, promote healthy beverages, and provide nutritional information for food served. The policy models the American Medical Association's policy, which MSDC's delegation also introduced.
In addition to these items, the Board took the following actions:
- Approving the deadline to renew membership dues of March 31
- Approving the 2022 Investment Policy Statement
- Approving contracting with GRF CPAs for the annual audit.
The Board heard a presentation from the Chair regarding COVID statistics in DC as well as expectations for Board members. The Board also discussed recent advocacy victories including:
- Introduction of legislation to reform prior authorization in DC
- Dr. Laurie Duncan testifying at the DC Health oversight hearing
- MSDC submitting testimony on legislation supporting FGM prohibition and stating concerns with CFSA policy on positive toxicology screenings during their oversight hearing
The meeting began with a presentation by Unity Insurance on its offerings for medical practices and physicians. Unity is MSDC's newest corporate partner and insurance option for DC physicians. For more information, see our press release.
The next MSDC Board meeting will be April 25, 2022. MSDC members in good standing may request an invitation to attend from Robert Hay Jr.