The Patient Protection and Affordable Care Act reduced federal funding for Medicaid disproportionate share hospital (DSH) payments, under the assumption that hospital uncompensated care costs would decline as insurance coverage increased. The initial $2 billion reduction in federal DSH allotments is scheduled to go into effect in fiscal year (FY) 2018.
This issue brief summarizes MACPAC’s projections of fiscal year 2018 state DSH allotments under current law, previously described in MACPAC’s March 2017 Report to Congress on Medicaid and CHIP, and provides new projections of changes in DSH allotments under the American Health Care Act, as passed by the U.S. House of Representatives on May 4, 2017, and the Senate Better Care Reconciliation Act discussion draft, as released on July 13, 2017.
For state-by-state projections of Medicaid DSH payments under current law as well as breakdowns of projected DSH funding under the AHCA and BCRA, please go to the state policy compendium, Projections of Federal Disproportionate Share Hospital Allotments and Safety-Net Payments under Proposed Legislation.
