# What the District of Columbia Medicaid Fairness Act Does

This bill changes how much federal money the District of Columbia receives to help pay for Medicaid, the health insurance program for low-income people. Right now, DC gets a certain percentage of federal funding for its Medicaid program based on a standard formula. This bill would guarantee DC receives at least 70 percent federal funding through 2026, then gradually reduces that guarantee over the next few years.

Here's how the money would work: From now through 2026, DC is guaranteed to get 70 percent of its Medicaid costs covered by the federal government. Starting in 2027, that guarantee begins to phase out—dropping to 65 percent in 2027, 60 percent in 2028, and 55 percent in 2029. After 2029, DC would go back to whatever percentage it would normally receive under the standard federal formula. The bill essentially gives DC a temporary boost in federal funding that gradually disappears over a few years.

This matters because it affects DC's ability to pay for Medicaid services for its residents. When the federal government covers more of the cost, DC has to spend less of its own money on the program, leaving more resources for other city services. Once the guarantee phases out, DC will likely have to either spend more of its own budget on Medicaid or potentially reduce benefits and services. The bill's supporters argue DC deserves this fairness adjustment, though the practical impact depends on what percentage DC would normally receive without this special treatment.