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Statement on CMS Proposed Rule on Medicaid DSH Reductions

May 13, 2013

Statement attributable to:
Bruce Siegel, MD, MPH
President and Chief Executive Officer
National Association of Public Hospitals and Health Systems

WASHINGTON – “The Affordable Care Act’s disproportionate share hospital reductions are neither justified nor sustainable – especially in light of the Supreme Court’s decision on Medicaid expansion. We must delay these cuts until we fully understand how the court’s decision will affect the number of uninsured and levels of uncompensated care.”

“We appreciate that the Centers for Medicare and Medicaid Services, with its rule today, appears to share this concern by proposing a reduction methodology for only 2014 and 2015. This is welcome news and aligns with President Obama’s cautious approach to the cuts by recommending a year delay in his recent fiscal year 2014 budget proposal.”

“We’re also pleased the agency focused the rule on how well states target DSH funding toward high-need hospitals within a state. We support that approach, particularly given the blunt cuts the ACA mandates.”

“Today’s rule appears to recognize that the fluid nature of coverage expansion and uncertain future for uncompensated care preclude a long-term rule on the DSH reduction methodology. We agree, and further believe Congress should delay the Medicaid DSH cuts to allow time for informed, rational discussions on DSH funding. We also believe that, regardless of how the cuts are made, states must do the right thing for the uninsured and other vulnerable people and move forward with expansion as quickly as possible.”

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About the National Association of Public Hospitals and Health Systems (NAPH)
NAPH represents the nation’s safety net hospitals and health systems, which provide high volumes of care to low-income individuals. These facilities offer high-quality health services for all patients, including the uninsured and underinsured, regardless of ability to pay. In addition to helping ensure access to health care for all Americans, safety net hospitals provide many essential communitywide services, such as primary care, trauma care, and neonatal intensive care. Safety net hospitals also train many of America’s doctors, nurses, and other health care providers. Since its inception in 1980, NAPH has cultivated a strong presence on Capitol Hill, with the executive branch, and in many state capitols. NAPH advocates on behalf of its members on such issues as Medicaid, Medicare, and access to health care services for vulnerable populations. For more information, visit our website at

Media Contact:
Carl Graziano


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