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Safety Net Hospitals Raise Concerns on DSH Cuts

John Commins, for HealthLeaders Media, June 14, 2012

The nation's safety net hospitals are concerned that the proposed cuts to disproportionate share payments that take place next year under the Patient Protection and Affordable Care Act may not be on the same timetable as the expansion of health insurance coverage.

Beth Feldpush, vice president for advocacy and policy at the National Association of Public Hospitals, says that specific cuts to DSH payments were written into the ACA regardless of whether or not healthcare coverage is extended to an additional 50 million people who are currently uninsured.

"We remain very concerned about the size of the DSH cuts," Feldpush told HealthLeaders Media. "With a little bit of hindsight at the ACA and looking at where we are with implementation, we are concerned we are not going to see coverage expand as quickly as we would optimally hope it would. I haven't seen anyone really do an estimate of how quickly we would get to that full coverage expansion."

DSH payment cuts totaling more than $22 billion for Medicare and $18.1 billion for Medicaid over 10 years are supposed to take effect beginning in federal fiscal year 2014, Feldpush says.

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