Medicaid Disproportionate Share

The Medicaid Disproportionate Share (DSH) program provides payments to hospitals that serve a disproportionate number of Medicaid and uninsured patients. The Patient Protection and Affordable Care Act (PPACA) reduces DSH payments by $14 billion from 2014 through 2019. In addition, when making decisions regarding the allocation of remaining DSH funds, the Secretary of Health and Human Services (HHS) is instructed to look at the percentage of a state's reduction of the uninsured, and whether a state targets DSH funds to hospitals with high Medicaid volumes or uncompensated care.

Due to an arbitrary cap on DSH payments frozen since the early 1990s, Florida is inequitably funded for DSH payments relative to other states with much lower uninsured populations. Currently more than four million Floridians are uninsured,  yet the state receives less than $55 per uninsured individual while other states receive as much as $1,500 per uninsured individual. Even if PPACA is fully implemented, Florida will still provide significant uncompensated care to the approximately two million remaining uninsured citizens.

FHA urges the HHS Secretary to allocate the remaining DSH funds in an equitable manner that appropriately targets DSH payments to allow for the continued provision of care to Floridians.

For more information, contact FHA Senior Vice President Karen Zeiler.