[Congressional Record (Bound Edition), Volume 161 (2015), Part 12]
[Extensions of Remarks]
[Page 17456]
[From the U.S. Government Publishing Office, www.gpo.gov]




THE INTRODUCTION OF THE DISTRICT OF COLUMBIA MEDICAID REIMBURSEMENT ACT 
                                OF 2015

                                 ______
                                 

                       HON. ELEANOR HOLMES NORTON

                      of the district of columbia

                    in the house of representatives

                      Wednesday, November 4, 2015

  Ms. NORTON. Mr. Speaker, today, I introduce the District of Columbia 
Medicaid Reimbursement Act of 2015 as open enrollment begins this week 
for the Patient Protection and Affordable Care Act. That important 
legislation, among other things, expands eligibility for Medicaid to 
reduce the number of Americans without health insurance. My bill 
increases the federal government's reimbursement for a portion of the 
District's Medicaid costs from 70 to 80 percent. In 2012-2013, New York 
City, the jurisdiction that powers the economy of New York State, 
contributes a 20 percent share for Medicaid costs, while the state pays 
33 percent, less than the District's federally mandated 30 percent 
contribution.
  Medicaid is financed mostly by the federal government and the states. 
However, the District, a city with no state to contribute to it, must 
alone absorb the state portion of Medicaid. Thus, the District pays for 
30 percent of Medicaid, more than any U.S. city. Considering the 
difference in the size of its tax base, the District should certainly 
contribute no more than the New York City contribution to Medicaid. 
Therefore, my bill would raise the federal contribution to the 
District's Medicaid program to 80 percent, equal to that of New York 
City.
  Under the National Capital Revitalization and Self-Government 
Improvement Act of 1997 (Revitalization Act), Congress recognized that 
state costs are inappropriate for any city to shoulder. To address this 
unfairness to the District, the Revitalization Act transferred certain, 
but not all, state responsibilities from the District to the federal 
government, including the cost of 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 our 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 rightful federal contribution.
  I urge my colleagues to join me in supporting the bill.

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