[Congressional Record Volume 157, Number 45 (Thursday, March 31, 2011)]
[Extensions of Remarks]
[Page E587]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




iNTRODUCTION OF THE DISTRICT OF COLUMBIA MEDICAID REIMBURSEMENT ACT OF 
                                  2011

                                 ______
                                 

                       HON. ELEANOR HOLMES NORTON

                      of the district of columbia

                    in the house of representatives

                        Thursday, March 31, 2011

  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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