Premier urges Congress to remove Medicaid DSH and uncompensated care cuts from reconciliation package

Nov. 5, 2021

Premier joined seven other national hospital organizations in urging Congressional leaders to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the latest version of the Build Back Better Act (H.R. 5376).

Congressional Democrats and the White House released an updated framework and legislative text for their social spending legislation that imposes reductions in federal Medicaid DSH Hospital allotments and federal funding for uncompensated care pools for states that fail to expand their Medicaid program. It is estimated the Medicaid DSH cuts affecting hospitals in these states would be between $4.3 billion and $7.8 billion over 10 years (2023-2031). In the future, if a state decides to curtail its Medicaid expansion, its federal DSH allotment also would be reduced.

In a letter, Premier and the other hospital groups asked House Speaker Nancy Pelosi (D-CA) and Senate Majority Leader Chuck Schumer (D-NY) to remove these cuts from any final bill, underscoring the financial hardship they would place on already strained hospitals serving vulnerable communities in non-expansion states—particularly while they continue to lead the fight against the COVID-19 pandemic.

Thanks to the American Rescue Plan Act of 2021 (ARP), nearly all Medicaid and CHIP beneficiaries are eligible to receive coverage of COVID-19 vaccines and their administration without cost-sharing. Beneficiaries with Medicare pay nothing for COVID-19 vaccines or their administration, and there is no applicable copayment, coinsurance, or deductible. COVID-19 vaccines and their administration will also be covered without cost-sharing for eligible consumers of most issuers of health insurance in the commercial market. People can visit (English) or (Spanish) to search for nearby locations to receive a vaccine.

Additionally, under the terms of the CDC COVID-19 Vaccination Program Provider Agreement, healthcare providers and other entities administering COVID-19 vaccines must agree not to deny anyone a COVID-19 vaccination based on their health coverage status and must also agree to administer COVID-19 vaccines at no out-of-pocket cost to recipients.

Premier release