[Congressional Record (Bound Edition), Volume 159 (2013), Part 3]
[Extensions of Remarks]
[Page 3995]
[From the U.S. Government Publishing Office, www.gpo.gov]




INTRODUCTION OF THE DISTRICT OF COLUMBIA MEDICAID REIMBURSEMENT ACT OF 
                                  2013

                                 ______
                                 

                       HON. ELEANOR HOLMES NORTON

                      of the district of columbia

                    in the house of representatives

                        Tuesday, March 19, 2013

  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 of the bill.

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