Introduction of the District of Columbia Medicaid Reimbursement Act of 2013

Floor Speech

Ms. NORTON. Mr. Speaker, as we approach the third anniversary of the enactment of the Patient Protection and Affordable Care Act, March 23, 2013, which, among other things, expands eligibility for Medicaid to reduce the number of Americans without health insurance, I introduce the District of Columbia Medicaid Reimbursement Act of 2013 today to increase the federal government's reimbursement for the District of Columbia's Medicaid costs from 70 to 75 percent. Medicaid is financed mostly by the federal government and the states. However, the District, a city that has no state to support it, must alone absorb the state portion of Medicaid. For example, the District pays for 30 percent of Medicaid. New York City pays less than 25 percent, since a 2005 state law reduced its contribution from 25 percent. The District certainly should pay no more than New York City's pre-2005 contribution and therefore my bill would raise the federal contribution to the District's Medicaid program to 75 percent. Considering the expansion of Medicaid eligibility under the new health care reform law, effective 2014, now is the time to make the District's Medicaid burden more equitable.

Under the National Capital Revitalization and Self-Government Improvement Act of 1997 (Revitalization Act), Congress recognized that state costs are too high for any city to shoulder. To address this unfairness to the District, the Revitalization Act transferred certain state responsibilities from the District to the federal government, including prisons and courts, and increased the federal Medicaid reimbursement to the District from 50 to 70 percent, partially relieving this burden. The city continues to carry many state costs, however.

In 1997, a formula error in the Medicaid Disproportionate Share Hospital allotment reduced the 70 percent Federal Medical Assistance Percentage share, and, as a result, the District received only $23 million instead of the $49 million it was due. I was able to secure a technical correction in the Balanced Budget Act of 1999, partially increasing the annual allotment to $32 million from fiscal year 2000 forward. I appreciate that in 2005, Congress responded to my effort to get an additional annual increase of $20 million in the budget reconciliation bill, bringing DC's Medicaid reimbursements to $57 million as intended by the Revitalization Act. However, this amount did not reimburse the District for the years the federal error denied the city part of its federal contribution, and, in any case, of course, was not intended to eliminate the District's structural deficit, which this bill partially addresses.

The bill is part of my series of bills for equal treatment of DC. The series of bills addresses inappropriate and often unequal restrictions placed only on the District, and no other U.S. jurisdiction.

I urge my colleagues to join me in support the bill.

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