Introduction of the District of Columbia Medicaid Reimbursement Act of 2011

Floor Speech

* Ms. NORTON. Mr. Speaker, I introduce the District of Columbia Medicaid Reimbursement Act of 2011 today to increase the Federal Government's reimbursement for a portion of the District of Columbia's Medicaid costs because the District is the only city, except for New York City, that pays any portion of Medicaid, an expense that is carried by the Federal Government and States. New York City, the jurisdiction that powers the economy of New York State, contributes a 25 percent share for Medicaid costs, while the state pays 25 percent, less than the District's federally mandated 30 percent contribution. The District's continuing responsibility for the share of Medicaid costs that are borne by entire states is a major component of the District's structural deficit and a threat to the financial stability of the city itself, according to the District's chief financial officer. Today, considering high unemployment in the District and 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 in the District, the Revitalization Act transferred certain state responsibilities from the District to the Federal Government, including prisons and courts, and the Act 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 (FMAP) 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 D.C.'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 the eighth in my ``Free and Equal D.C.'' series. 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 supporting the bill.

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