Medicaid DSH Payment Cuts By District


Although this year’s scheduled Medicaid Disproportionate Share Hospital (DSH) cuts have been postponed, the Texas Hospital Association is already looking ahead and ready to advocate for Congress to protect patient care by delaying or permanently repealing those cuts yet again in future years. THA has calculated the number of DSH hospitals and previously scheduled reduction amounts for each of the 38 U.S. House districts for FY 2024. See THA’s district-specific explainers listed below for details.

As of March 2024, following ongoing advocacy from THA, Texas hospitals and the American Hospital Association, Congress had repealed the pending Medicaid DSH cuts for federal fiscal year 2024 – which would have cost Texas safety-net hospitals an estimated $800 million – and also delayed the implementation of the following federal fiscal year cuts until Jan. 1, 2025. THA is continuing to push for further repeal of DSH cuts still scheduled to hit over the next several years, which would cost hospitals more than $2 billion. These funding cuts are unsustainable, especially considering Texas leads the nation with 17% of its population, or about 5 million Texans, lacking health insurance. DSH payments compensate hospitals that treat a disproportionate number of uninsured and Medicaid patients.

The Supporting Safety Net Hospitals Act (H.R. 2665), introduced in Congress in April 2023, would repeal the payment cuts for fiscal years 2024 ($8 billion) and 2025 ($8 billion), helping Disproportionate Share hospitals across Texas and the nation continue to receive billions in needed payments. THA and the American Hospital Association both support this bill, on which Texas Reps. Dan Crenshaw and Michael Burgess, MD, are original cosponsors. All members of the Texas congressional delegation are being asked to sign onto H.R. 2665.

Local Impact of DSH Cuts by Congressional District

U.S. Sen. John Cornyn
U.S. Sen. Ted Cruz
Rep. Nathaniel Moran (TX-1)
Rep. Dan Crenshaw (TX-2)
Rep. Keith Self (TX-3)
Rep. Pat Fallon (TX-4)
Rep. Lance Gooden (TX-5)
Rep. Jake Ellzey (TX-6)
Rep. Lizzie Fletcher (TX-7)
Rep. Morgan Luttrell (TX-8)
Rep. Al Luttrell (TX-9)
Rep. Michael McCaul (TX-10)
Rep. August Pfluger (TX-11)
Rep. Kay Granger (TX-12)
Rep. Ronny Jackson (TX-13)
Rep. Randy Weber (TX-14)
Rep. Monica De La Cruz (TX-15)
Rep. Veronica Escobar (TX-16)
Rep. Pete Sessions (TX-17)
Rep. Sheila Jackson Lee (TX-18)
Rep. Jodey Arrington (TX-19)
Rep. Joaquin Castro (TX-20)
Rep. Chip Roy (TX-21)
Rep. Troy Nehls (TX-22)
Rep. Tony Gonzales (TX-23)
Rep. Beth Van Duyne (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. Jasmine Crockett (TX-30)
Rep. John Carter (TX-31)
Rep. Colin Allred (TX-32)
Rep. Marc Veasey (TX-33)
Rep. Vicente Gonzalez (TX-34)
Rep. Greg Casar (TX-35)
Rep. Brian Babin (TX-36)
Rep. Lloyd Doggett (TX-37)
Rep. Wesley Hunt (TX-38)