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 Board of Medicine Meets, Discusses Issues Where MSDC Is Leading
MSDC attended the June 29 meeting of the DC Board of Medicine. As part of its meeting, there was a government affairs report on bills moving through the DC Council which impact the DC Board of Medicine. These include:
- Consent for Vaccinations of Minors Emergency Amendment Act of 2022 (Bill 24-890). This emergency legislation allows certain minors to seek CDC-approved vaccines without consent of a parent or legal guardian if a reasonable attempt is made to obtain such consent. The “reasonable attempt” requirement aims to address challenges from a federal judge who barred enforcement of DC’s existing law allowing minors to obtain vaccines without parental consent. The legislation was crafted using recommendations from the MSDC-led Minor Consent for Treatment Working Group created by the Committee on Health.
- Protecting Health Professionals Providing Reproductive Health Care Amendment Act of 2022 (Bill 24-830). This recently introduced bill would “prohibit disciplinary measures against licensed health professionals solely for providing abortion and reproductive health care services to patients who live in states where the services are illegal.” As introduced, the bill would prevent disciplinary action against a doctor, so long as the physician is acting within scope of practice. The bill has been referred to the Committee on Health. On a related note, see MSDC’s primer on abortion law in the District.
- High Need Health Care Careers Scholarship and Healthcare Loan Repayment Program Emergency Act (B24-852) Legislation passed the Committee of the Whole on emergency basis to establish scholarships and a support program “for the purpose of increasing the number of healthcare workers in high-need healthcare careers in the District by providing supports and services to individuals who agree to serve as such workers in the District.” The emergency legislation is under Mayoral review and permanent legislation to expand the program may be forthcoming.
On a related note, MSDC is a member of the DC Healthcare Workforce Task Force, which makes recommendations to the Mayor on the strategies and investments necessary to address current supply and demand challenges in the healthcare workforce.
The Board Chair indicated that she plans to review Federation of State Medical Boards policy on provider misinformation at a future meeting.
The DC Board of Medicine also reported its current licensees. As of June 2022, there were 12,628 physicians (MD, DO) licensed in the District of Columbia. The complete census is as follows: