The District of Columbia, which is not a state but a federal district, receives 70% of its Medicaid funds from the federal government, while the district covers 30% of Medicaid costs on its own. The higher permanent FMAP for D.C. was created in 1997 under the GOP Congress led by former House Speaker Newt Gingrich, preventing the district from falling to the minimum rate of 50%.

Congresswoman Eleanor Holmes Norton, D.C.’s nonvoting delegate in the House, and Democratic Congress members from districts in Virginia and Maryland near D.C. expressed their concern in a letter to congressional leaders over reports that D.C.’s FMAP could be reduced. The letter was sent to Rep. Brett Guthrie (R-KY), House Energy and Commerce Committee chairman, and Rep. Frank Pallone (D-NJ), a ranking member of the committee.

“Such a change would be catastrophic, destabilizing the healthcare system of the Washington, D.C., metropolitan region and beyond and impacting the hundreds of thousands of constituents who live, work, travel through, or receive care in D.C. each day. Notably, this includes Members of Congress and their staff, members of the administration, visiting dignitaries, and their families, as well as families across the country who rely on D.C.’s specialized care,” the lawmakers said.

“We all depend on and expect our nation’s capital to have a quality, responsive health care system. Efforts to weaken that system through cuts to Medicaid undermine the stability and resilience our region requires and would have reverberating effects across the country,” the lawmakers continued.

The lawmakers noted that the agreement was made because of Congress’s “unique revenue limitations on D.C.”

“Congress imposes three main revenue limitations on D.C.: D.C. cannot tax income earned in D.C. by nonresidents, depriving D.C. of more than $3 billion in revenue per year; D.C. cannot permit buildings to exceed certain height limitations; and D.C. cannot tax its sizable federal property,” the lawmakers said.

D.C. Mayor Muriel Bowser also expressed concern at a press conference Wednesday. She called cuts to Medicaid “one of the most cruel things” and discussed the effects they would have not only on D.C. but also on rural and poorer states. She said she believes “those states and senators will make the case for maintaining their match” as well.

COMMANDERS STADIUM DEAL FACES SPLIT OPINIONS ON DC COUNCIL

While Republicans have said they would not cut Medicaid, the House Energy and Commerce Committee, which oversees Medicaid, will have to cut funding by $880 billion to meet the fiscal 2026 budget target.

The Congressional Budget Office said some cuts to Medicaid or Medicare would be required to achieve the target for cuts.