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.
.png?sfvrsn=9ac2d21b_0 "What Medicaid Cuts Actually Cost")
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’s Final 2022 Meeting Focuses on Public Health and Licensure
MSDC attended the DC Board of Medicine’s final open session meeting of 2022 on December 14. The meeting started with a public health reminder that the District still faces multiple public health concerns. The District continues to monitor COVID-19, RSV, and other emerging and existing threats. Board of Medicine Chair Dr. Andrea Anderson stressed the importance of staying up-to-date on COVID-19 and other vaccines, even if they are not required, to protect both the public and the health care workforce. COVID-19 testing and resources remain available to the public.
The 2022 physician license renewal cycle is well underway and the December 31, 2022 deadline is just weeks away (See MSDC’s Physician License Renewal Info Center for need-to-know information). MSDC raised a concern to the Board of Medicine that physicians are experiencing delays in receiving their controlled substance (CS) license renewals, which are reviewed individually. Physicians are concerned at the possibility that their licenses will expire and impact their ability to treat patients effective January 1, 2023. Board of Medicine Executive Director Aisha Nixon indicated that there will be a 60-day grace period for physicians who submit their renewal application by the December 31, 2022, deadline.
The Board also indicated that it is continuing to move forward with the Interstate Medical Licensure Compact and interstate reciprocity. DC Health expects these initiatives to go live in the District in the 2nd quarter of 2023. MSDC has advocated for streamlined licensure through regional reciprocity and the Interstate Medical Licensure Compact.
The DC Board of Medicine reported its current licensees. As of December 2022, there were 13,198 physicians (MD, DO) licensed in the District of Columbia. The complete census is as follows:
| MEDICINE AND SURGERY | 12,535 |
| OSTEOPATHY AND SURGERY | 663 |
| ACUPUNCTURIST | 170 |
| ANESTHESIOLOGIST ASSISTANT | 124 |
| MEDICAL TRAINING LICENSE I(A) | 1,174 |
| MEDICAL TRAINING LICENSE I(B) | 323 |
| MEDICAL TRAINING LICENSE II | 28 |
| MEDICAL TRAINING REGISTRANT | 182 |
| NATUROPATH PHYSICIAN | 66 |
| PHYSICIAN ASSISTANT | 1,242 |
| POLYSOMNOGRAPHIC TECHNICIAN | 1 |
| POLYSOMNOGRAPHIC TECHNOLOGIST | 69 |
| POLYSOMNOGRAPHIC TRAINEE | 3 |
| SURGICAL ASSISTANT | 122 |
| CHINESE HERBOLOGY | 25 |
| 16,727 |