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
November is Long-Term Care Awareness Month
Content provided by UnitedHealthcare Community & State District of Columbia
November is National Long-Term Care Awareness Month, and the UnitedHealthcare Dual Choice Plan offers a wide range of benefits to eligible enrollees who reside in the District. Long-term services and supports (LTSS) refers to a broad range of medical, functional, and social services that are needed by individuals who have complex health needs due to aging, chronic illness, or disability. These services can be provided in a range of settings, including nursing homes, assisted living facilities, convalescent homes, and home and community-based settings. Medicaid serves as the largest payer for LTSS. The need for LTSS is generally measured by limitations in one’s ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs), both of which allow individuals to live independently in their communities.
LTSS are delivered in a variety of settings, including home- and community-based settings (e.g., adult day services and personal care/homemaker services) and institutional care (e.g., intermediate care facilities for people with intellectual and developmental disabilities and nursing homes).
LTSS programs are administered either in nursing facilities or through Home- and Community-Based Services (HCBS). HCBS support people as they continue to live in their home or a setting of their choosing. Individuals who receive HCBS still make appointments and go to a medical facility for care, but they also receive wraparound services in their community or directly in their home.
Approximately 14 million individuals need LTSS in the United States today. Most of these individuals want to stay in their residence for as long as possible, making HCBS the more desirable choice for many individuals needing LTSS. HCBS also offer considerable cost savings for states, with nursing home care costs 73% greater than the cost of care in the community.