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
DC Residents Will Have Access to UnitedHealthcare’s District Dual Choice Program – Individuals Eligible for Medicare and Medicaid
The District Dual Choice Program provides comprehensive, coordinated health benefits to eligible adults (aged 21+) who qualify for Medicare and Medicaid. This comprehensive health coverage offers a customized care plan and a single point of contact for all Medicare and DC Medicaid services. UnitedHealthcare will continue to work closely with the Department of Health Care Finance (DHCF) to improve the overall health and well-being of enrollees through a value-based, whole-person, and integrated care model.
Integrated care is changing the way patients receive their care by focusing on care of the whole person. Physical health and behavioral health are significantly correlated, but historically the systems that deliver physical and behavioral health services have been built and developed independently, with no formal, system-level coordination. By integrating behavioral health and Long-Term Services and Supports (LTSS) into the District Dual Choice Program, UnitedHealthcare can provide a comprehensive approach to care coordination across medical and behavioral services, improve and simplify enrollee and provider experiences, reduce administrative costs, and enhance health plan ability to deliver on state goals.
UnitedHealthcare works for enhanced and deeper provider partnerships through value-based contracting, including Home and community-Based Services (HCBS) providers. This creates an enrollee-centered approach in caring for enrollees while continuing to meet them where they are, resulting in effectively coordinated care. Enrollees can continue to access core Medicare benefits along with Part D (pharmacy) benefits and targeted clinical programs and services. Additionally, the plan offers supplemental benefits and services that are not typically available through Original Medicare or Medicaid at no extra cost. These may include dental coverage, routine vision care, allowance for certain over-the counter items and healthy food, and more.
For more information about Provider Resources visit UnitedHealthcare Community Plan of District of Columbia Homepage | UHCprovider.com.