This legislation, known as the "District of Columbia Medicaid Fairness Act," proposes significant changes to the Federal Medical Assistance Percentage (FMAP) for the District of Columbia under Title XIX of the Social Security Act. The bill aims to modify how the federal government contributes to D.C.'s Medicaid program, specifically by adjusting its enhanced federal matching rate. Under the proposed amendment, D.C.'s Medicaid FMAP would be set at 70 percent for fiscal years before 2027. Subsequently, the FMAP would see a phased reduction, decreasing to 65 percent in fiscal year 2027, 60 percent in fiscal year 2028, and finally 55 percent in fiscal year 2029. Beginning in fiscal year 2030, the District of Columbia's FMAP would no longer be subject to these specific percentages and would instead be determined by the standard FMAP calculation applicable to other states.