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Cuts to Medicare Payments for Uninsured Begin

Chelsea Rice, for HealthLeaders Media, October 1, 2013

"Delaying the DSH cuts will help ensure that hospitals that serve high volumes of uninsured patients can continue to provide needed services to their communities," said Rick Pollack, executive vice president of the American Hospital Association in a prepared statement. "Maintaining DSH payments is vital to hospitals that care for the uninsured. We look forward to working with Congress to delay the reductions and provide vital support for hospitals that serve the most vulnerable." 

In 2012, the Medicaid DSH payments for all states and the District of Columbia were estimated to be $11.34 billion. CMS will reduce Medicaid DSH payments by $500 million in FY 2014 and $600 million in FY 2015, increasing annually. The program will face cuts of $5 billion in 2018, $5.6 billion in 2019, and $4 billion in 2020.

America's Essential Hospitals, formerly the 200-member National Association of Public Hospitals and Health Systems (NAPH), has been advocating in Congress for an improved DSH payment system that reflects the reality of the front-lines of care today. The hold-up, reflecting much of politics today, has been largely political, says Shawn Gremminger, assistant VP of legislative affairs at America's Essential Hospitals.

"Politics gets in the way. We often hear back 'I agree with you, I see there's a problem.' But in Republicans' cases they often say my boss opposes the PPACA, and we want a wholesale change. The Democrats' response is typically 'I'd like to help, but with Republican attacks I can't afford to do anything that changes the PPACA, and we need to defend the law in its entirety," said Gremminger.

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