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 Health Issues New Guidance on RSV, Return to Work, and PPE
DC Health has issued a series of guidance documents reflecting COVID updates and new public health concerns.
Most pressing is a new respiratory viral illness alert issued on November 9. The alert highlights the high levels of flu and RSV being seen in the population, similar to the experience of many DC physicians. The department notes that flu season began four weeks earlier this year than usual, resulting in higher numbers of severe cases. The alert seen here offers guidance and information for DC physicians and their offices.
In addition, DC Health updated their healthcare personnel monitoring, restriction, and return to work guidance on November 4. This guidance is for employers of health care personnel (HCP) and includes best practice recommendations related to masking, eye protection, and HCP exposure, monitoring, and work restrictions for COVID-19. Except for current mandates in effect under a Mayor’s Order or other existing local or federal regulation, any definitive action statements made in this guidance (e.g., “must”) are considered essential best practice recommendations to mitigate the spread of COVID-19. HCP include all paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials. You can see the newest guidance here.
You can also view the most recent guidance on PPE here (issued 10/25) and guidance for close contacts with a COVID-19 positive person here (issued 10/25)
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