America’s Essential Hospitals has prepared an analysis of provisions in the Graham-Cassidy-Heller-Johnson proposal that would affect Medicaid disproportionate share hospital (DSH) payments.

Policy Brief – Analysis of Medicaid DSH Provisions in Graham-Cassidy-Heller-Johnson Plan


  • Unlike the American Health Care Act and Better Care Reconciliation Act, the Graham-Cassidy proposal provides no systemic relief from DSH cuts for states.
  • DSH provisions in the bill do not counterbalance the higher uncompensated care costs that would result from per-capita caps or block grants for the base Medicaid program.
  • States would not be eligible to receive DSH funds beyond the amount they would receive under their current allotment. This limited relief is insufficient to make up for the total grant shortfall expected in many states.