Bill Summary
The proposed "District of Columbia Medicaid Fairness Act" seeks to amend the Social Security Act to establish a more equitable Federal Medical Assistance Percentage (FMAP) for Medicaid funding in the District of Columbia (D.C.). The legislation specifies that:
1. The FMAP for D.C. will be set at 70% for fiscal years leading up to 2030, ensuring that D.C. receives a minimum level of federal funding for Medicaid services.
2. Starting in fiscal year 2030, the FMAP for D.C. will revert to the standard calculation without the minimum percentage clause.
3. For fiscal years 2027, 2028, and 2029, the FMAP will gradually decrease to 65%, 60%, and 55% respectively.
This adjustment aims to provide a fairer distribution of Medicaid funds to D.C., addressing disparities in federal support compared to other states, particularly in light of D.C.'s unique status and healthcare needs.
Possible Impacts
The "District of Columbia Medicaid Fairness Act" as described could affect people in several ways. Here are three examples:
1. **Increased Funding for Medicaid Services**: By adjusting the Federal Medical Assistance Percentage (FMAP) for the District of Columbia to 70% initially, the legislation would increase federal funding for Medicaid services. This could lead to improved healthcare access for low-income residents of D.C., allowing them to receive necessary medical care, preventive services, and mental health support, ultimately improving their overall health outcomes.
2. **Gradual Decrease in Federal Support**: The legislation outlines a gradual decrease in the FMAP over the years, moving from 70% to 55% by fiscal year 2029. This reduction could result in a significant decrease in federal funding for Medicaid in the District of Columbia, potentially leading to cuts in services, increased costs for beneficiaries, or higher eligibility restrictions. Residents who rely on Medicaid might find it more challenging to access the care they need, particularly as funding decreases.
3. **Impact on Health Providers**: Healthcare providers and institutions that serve Medicaid patients in D.C. could be affected by both the increase and subsequent decrease in federal funding. Initially, the higher FMAP might allow providers to expand services or hire additional staff. However, as the FMAP decreases, providers may face financial strain, leading to a reduction in services offered, longer wait times for patients, or even the closure of facilities that rely heavily on Medicaid reimbursements. This could disproportionately affect vulnerable populations who depend on these services.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5815 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 5815
To amend title XIX of the Social Security Act to bring fairness to the
Medicaid Federal medical assistance percentage for the District of
Columbia.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 24, 2025
Mr. Cloud (for himself, Mr. Arrington, Ms. Van Duyne, Mr. Tiffany, Mr.
Clyde, Mr. Brecheen, Mr. Steube, Mr. Roy, and Mr. Harris of Maryland)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to bring fairness to the
Medicaid Federal medical assistance percentage for the District of
Columbia.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``District of Columbia Medicaid
Fairness Act''.
SEC. 2. ADJUSTMENT OF FMAP FOR DISTRICT OF COLUMBIA.
Section 1905 of the Social Security Act (42 U.S.C. 1396d) is
amended--
(1) in the first sentence of subsection (b), by striking
``this title'' and everything that follows through ``shall be
70 percent'' and inserting ``title XXI, the Federal medical
assistance percentage for the District of Columbia shall be 70
percent, and for purposes of this title, for fiscal years
before 2030, the Federal medical assistance percentage for the
District of Columbia shall be equal to the percentage that
would otherwise be determined under this subsection without
application of this clause or the percentage specified in
subsection (ll) for such fiscal year (whichever is greater),
and for fiscal year 2030 and each subsequent fiscal year, the
Federal medical assistance percentage for the District of
Columbia shall be equal to the percentage that would otherwise
be determined under this subsection without application of this
clause''; and
(2) by adding at the end the following new subsection:
``(ll) Federal Medical Assistance Percentage for the District of
Columbia.--For purposes of clause (3) of the first sentence of
subsection (b), the percentage specified in this subsection for a
fiscal year is--
``(1) for a fiscal year before fiscal year 2027, 70
percent;
``(2) for fiscal year 2027, 65 percent;
``(3) for fiscal year 2028, 60 percent; and
``(4) for fiscal year 2029, 55 percent.''.
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