Local Impact of Medicaid Disproportionate Share Hospital Payment Cuts
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Under current law, all states' federal Medicaid DSH allotments were scheduled to be reduced by $4 billion in federal fiscal year 2020 (beginning Oct. 1, 2019). Cuts will increase to $8 billion a year in fiscal years 2021 to 2025. 

In late September, the U.S. Congress passed a short-term budget that delayed the cuts to Nov. 21, 2019. Texas hospitals urge the U.S. Congress to eliminate permanently or, at a minimum, delay for two years the impending Medicaid DSH cuts. 

Earlier in September, the Centers for Medicare & Medicaid Services published its final rule describing its methodology for distributing the federal DSH allotment reductions. CMS will calculate individual states’ DSH reductions using each respective year’s preliminary DSH allotment as currently calculated under statue.

The Medicaid and CHIP Payment Access Commission estimates the reduction will be $450 million, or 22.8 percent of DSH payments, in 2020. The estimated cumulative reduction for fiscal years 2020 through 2025 totals $4.95 billion for Texas.

A bipartisan DSH letter, co-led by Rep. Pete Olson (TX-22), to delay scheduled Medicaid DSH cuts for two years, was submitted to the House leadership in May. 

In addition to Rep. Olson,  29 members of the Texas Congressional delegation signed on to the letter (Reps. Allred, Arrington, Babin, Bernice Johnson, Carter, Castro, Cloud, Conaway, Crenshaw, Cuellar, Doggett, Escobar, Fletcher, Flores, Garcia, Gooden, Granger, Green, Gohmert, Gonzalez, Hurd, Jackson Lee, McCaul, Thornberry, Veasey, Vela, Weber, Williams and Wright). THA members are encouraged to thank these members for their support.

See how the DSH payment cuts under current law impact your Congressional district using the resources on this page.

Rep. Louie Gohmert (TX-1)
Rep. Daniel Crenshaw (TX-2)
Rep. Van Taylor (TX-3)
Rep. John Ratcliffe (TX-4)
Rep. Lance Gooden (TX-5)
Rep. Ronald Wright (TX-6)
Rep. Lizzie Pannill Fletcher (TX-7)
Rep. Kevin Brady (TX-8)
Rep. Al Green (TX-9)
Rep. Michael McCaul (TX-10)
Rep. Mike Conaway (TX-11)
Rep. Kay Granger (TX-12)
Rep. Mac Thornberry (TX-13)
Rep. Randy Weber (TX-14)
Rep. Vicente Gonzalez (TX-15)
Rep. Veronica Escobar (TX-16)
Rep. Bill Flores (TX-17)
Rep. Sheila Jackson Lee (TX-18)
Rep. Jodey Arrington (TX-19)
Rep. Joaquin Castro (TX-20)
Rep. Chip Roy (TX-21)
Rep. Pete Olson (TX-22)
Rep. Will Hurd (TX-23)
Rep. Kenny Marchant (TX-24)
Rep. Roger Williams (TX-25)
Rep. Michael Burgess (TX-26)
Rep. Michael Cloud (TX-27)
Rep. Henry Cuellar (TX-28)
Rep. Sylvia Garcia (TX-29)
Rep. Eddie Bernice Johnson (TX-30)
Rep. John Carter (TX-31)
Rep. Colin Allred (TX-32)
Rep. Marc Veasey (TX-33)
Rep. Filemon Vela (TX-34)
Rep. Lloyd Doggett (TX-35)
Rep. Brian Babin (TX-36)

Contacts

John Hawkins, senior vice president of government relations, 512/465-1505

Kate Hendrix, senior director, policy analysis, 512/465-1556

Letter to DSH
Engel-Olson Letter to DSH