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
MSDC Sends Letter to Senate on Healthy Meals, Healthy Kids Act
On December 9, MSDC President Dr. Susanne Bathgate sent a letter on behalf of MSDC to the Chair and Ranking Member of the Senate Agriculture Committee advocating for updates to the federal dietary guidelines. As the Senate considers omnibus spending legislation for the rest of the federal fiscal year, there is consideration to adding language modernizing dietary guidelines.
The letter is included below.
December 9, 2022
Dear Chair Stabenow and Ranking Member Boozman:
The Medical Society of the District of Columbia was founded in 1817 and remains dedicated to ensuring the health and well-being of the citizens of Washington, DC. We understand that the House Education and Labor Committee advanced language earlier this year in the Healthy Meals, Healthy Kids Act (H.R. 8450) that would address the issue of beverage availability for schoolchildren and that Congress is currently deliberating its further consideration.
As the Senate Agriculture Committee considers provisions for possible inclusion in a year-end omnibus bill, we want to let you know that the Medical Society of the District of Columbia supports the policy of the American Medical Association entitled “Culturally Responsive Dietary and Nutritional Guidelines” that calls for the passage of federal legislation that “modifies the National School Lunch Act, 42 U.S.C. § 1758, so as to eliminate requirements that children produce documentation of a disability or a special medical or dietary need in order to receive an alternative to cow’s milk.”
We are grateful to you for all you do you advance public health. On behalf of our physician members, as well as patients and families in the District of Columbia and across the nation, we thank you for your attention to this important issue.
Sincerely,
Susanne Bathgate, MD
President, Medical Society of DC