In a rare display of bipartisanship, more than 220 lawmakers banded together in a call to U.S. House of Representative leaders for swift action to avert looming cuts to Medicaid disproportionate share hospital funding, a move that was lauded by America's Essential Hospitals.
Without congressional intervention, a $2 billion cut to DSH funding will happen Oct. 1, the start of the federal fiscal year. The Affordable Care Act mandated the cuts, assuming counterbalancing increases in coverage -- increases that fell short of estimates after the U.S. Supreme Court made Medicaid expansion optional.
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In a Sept. 28 letter to House Speaker Rep. Paul Ryan, R-WI, and Minority Leader Rep. Nancy Pelosi, D-CA, 162 Democrats and 59 Republicans from 41 states called for a delay of the cuts for at least two years -- or until Congress can find a "sustainable, permanent solution" to the inequity of DSH cuts with uncompensated care billions of dollars higher than expected.
"The support for a DSH delay from both sides of the aisle is gratifying and appreciated," said Bruce Siegel, MD, MPH, president and CEO of America's Essential Hospitals, in a statement. "Bipartisanship is not dead in Washington -- this letter underscores that point and reflects the widespread threat these cuts pose to patients and communities."
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The 221 signers of the letter to Ryan and Pelosi come from 27 of 31 Medicaid expansion states and 14 of 19 non-expansion states. They also include five House committee chairs and 13 committee ranking members.
"This is not a red state issue or a blue state issue. These cuts will jeopardize access to care and vital community services -- trauma care, disaster response, and others -- in all states," Siegel said. "Congress must act quickly."
The 325 members of America's Essential Hospitals provide 17 percent of all uncompensated care nationally, a commitment to low-income patients that typically comes with narrow or negative operating margins. Congress designed DSH to help compensate hospitals for this safety net work.
On three previous occasions, Congress delayed DSH cuts in strongly bipartisan votes, including as part of the Bipartisan Budget Act of 2013, the Protecting Access to Medicare Act of 2014, and the Medicare Access and CHIP Reauthorization Act of 2015.
America's Essential Hospitals recently organized another letter asking Congress to delay the DSH cuts. That letter carried the signatures of executives at more than 280 member and nonmember hospitals nationally.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com