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
September 20 is MSDC Day of Action on Prior Auth and Copay Accumulators
It's time for the DC Council to hear the physician community speak at once on the biggest prescription issues impacting our patients.
MSDC and our partners are launching a day of action on two critical bills that if passed could radically change medicine in DC for the better. Both bills are top priority for the Society and our members, and bills that are widely supported by physicians.
We are asking you, your practice managers, your staff, and patients to contact the DC Council on September 20 and push the Council to pass this year two bills:
- B24-655, the Prior Authorization Reform Act. This bill would improve the prior authorization process by setting limits on who, when, and how payers can slap prior auths on our medical decisions. This bill has not had a hearing and needs to have a hearing to pass committee.
- B24-557, the Copay Accumulators Amendment Act. This bill prevents insurers from penalizing patients from using coupons and discounts for specialty drugs. This bill had a hearing - with testimony overwhelmingly in favor - but needs a mark-up to go to the full Council.
How can you participate in the Day of Action? It's easy, not time consuming, and fits into your busy schedule. And MSDC will help:
- Look up who are the Councilmembers for your home (if you're a DC resident) and/or practice. You can find your Ward here. Remember your location is represented by your Ward Councilmember, at-large Councilmembers, and the Council Chair.
- Email your Councilmembers and their staff asking them to support either or both bills (if they are not already a supporter) and support them being added to the Council agenda this year after markup in the Health Committee.
- You can also call your Councilmembers with the same ask. Call the office number and ask to speak to the Councilmember or staff person for the issue.
- If you have time, visit your members' offices. Be aware there are visitor restrictions at the Wilson Building.
- Let MSDC know who you contact by emailing hay@msdc.org