District of Columbia Medicaid Fairness Act

Bill Number

H.R. 5815

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Health

Status

Introduced

Latest Action

2025-10-24: Referred to the House Committee on Energy and Commerce.

Last Updated

2026-01-14T09:06:47Z

AI-Generated Summary

Purpose This legislation amends the Social Security Act to adjust the Federal medical assistance percentage (FMAP)—the share of Medicaid costs paid by the federal government—for the District of Columbia, aiming to reduce its currently elevated rate over time.

Key Provisions

• The bill phases down the FMAP for the District of Columbia as follows: 70 percent before fiscal year 2027, 65 percent in 2027, 60 percent in 2028, and 55 percent in 2029.
• For fiscal years before 2030, the FMAP is set at the higher of the standard calculated rate or the phased rate.
• Beginning in fiscal year 2030, the FMAP reverts to the standard calculation used for other jurisdictions without any special adjustment.

Significant Changes to Existing Law Current law provides the District of Columbia with a fixed 70 percent FMAP. This bill replaces that fixed rate with a gradual reduction schedule, aligning DC's matching percentage more closely with other areas by 2030.

Potential Impacts

• Federal spending on Medicaid in the District of Columbia would decrease over the phase-down period.
• The District of Columbia government would likely need to cover a larger share of Medicaid costs, which could affect its budget or program administration.
• Medicaid recipients in the District could face indirect effects if the city adjusts eligibility, benefits, or provider payments to manage higher local costs.
• No direct effects on international relations are outlined.

Main Stakeholders Affected

• The District of Columbia government and its Medicaid program.
• Residents of the District who receive Medicaid coverage.
• Federal agencies responsible for Medicaid administration, such as the Centers for Medicare & Medicaid Services.
• Members of Congress involved in funding and oversight of the District.

Notable Legal, Constitutional, or Political Implications The bill operates within Congress's authority to set funding levels for the District of Columbia, a jurisdiction without state status. It does not alter constitutional structures but addresses differences in federal matching rates between the District and the states.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Cloud, Michael [R-TX-27]

Cosponsors (18)

Rep. Arrington, Jodey C. [R-TX-19], Rep. Van Duyne, Beth [R-TX-24], Rep. Tiffany, Thomas P. [R-WI-7], Rep. Clyde, Andrew S. [R-GA-9], Rep. Brecheen, Josh [R-OK-2], Rep. Steube, W. Gregory [R-FL-17], Rep. Roy, Chip [R-TX-21], Rep. Harris, Andy [R-MD-1], Rep. Higgins, Clay [R-LA-3], Rep. Hageman, Harriet M. [R-WY-At Large], Rep. Biggs, Sheri [R-SC-3], Rep. Cline, Ben [R-VA-6], Rep. Gill, Brandon [R-TX-26], Rep. Pfluger, August [R-TX-11], Rep. Fallon, Pat [R-TX-4], Rep. Kennedy, Mike [R-UT-3], Rep. Allen, Rick W. [R-GA-12], Rep. Rose, John W. [R-TN-6]

Recent Actions

• 2025-10-24: Referred to the House Committee on Energy and Commerce.
• 2025-10-24: Introduced in House
• 2025-10-24: Introduced in House

Bill Versions

• District of Columbia Medicaid Fairness Act — issued 2025-10-24 — PDF (3 pages)