Dive Brief:
- Many states have refused the federal money available under the ACA to expand their Medicaid programs.
- Now, another part of the ACA is poised to cut disproportionate share payments to safety-net hospitals; for example, Atlanta's Grady Health, could lose half of its $100 million in annual subsidies.
- Cuts to DSH payments to safety-net hospitals should total $18 billion through 2020.
Dive Insight:
This combination of events -- a failure to expand Medicaid plus deep cuts in DSH payments -- is little short of a disaster for safety-net hospitals, some of which will doubtless face a grim prognosis under the circumstances. By leaving states with a choice whether or not to expand Medicaid, however, it was inevitable that some would opt out. Adding insult to inijury by cutting DSH patients is bad medicine. It increasingly appears that hospitals need to push for a legislative fix to this situation, one which either halts the DSH cuts or requires Medicaid expansion in the states.