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Safety-Net Hospitals Need Congress to Protect Patients

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It’s easy to be distracted by the news coming out of Washington, D.C., these days, much of which has little to do with sound policies that advance hospitals’ efforts to care for their patients. But on the issue of Medicaid disproportionate share hospital (DSH) payments, we cannot afford to lose focus in our fight against devastating funding cuts to hospitals that serve the uninsured and underinsured.

This issue tops our current federal advocacy priorities because it is time sensitive: the DSH cuts were scheduled to take effect on Oct. 1 but were briefly delayed by the current temporary spending bill. When that measure expires on Nov. 21, unless the cuts are eliminated or further delayed, they will take effect immediately.

Now is the time for a full-court press urging Congress to continue this vital source of funding for safety-net hospitals.

Medicaid DSH cuts were adopted as part of the Affordable Care Act, on the assumption that the number of uninsured Americans would decrease more than it has. In California, 2.9 million people remain without health insurance. Those patients are disproportionately served by our safety-net hospitals, which rely heavily on DSH payments to offset the cost of the uncompensated care they provide.

As planned, the cuts will be unsustainable for California’s safety-net hospitals, reducing DSH allotments in the state by $500 million in 2020 and by about $950 million a year from 2021 through 2025.

So far, members of Congress have been willing to delay these drastic reductions while millions remain without coverage, but the time has come to once again impress upon Congress the essential nature of DSH payments to safety-net hospitals and their patients. To that end, CHA is leading an effort to press the California congressional delegation to sign a letter that urges House Speaker Nancy Pelosi and Minority Leader Kevin McCarthy to support eliminating the cuts for another two years. 

Next week, we’ll be sending an Advocacy Alert to member hospitals, asking you to contact your representative about signing the letter. This is an issue that all hospitals should care about — because cuts of this magnitude will jeopardize access to care for millions.

For lawmakers to support a policy that diminishes access to care for California’s most vulnerable patients is unacceptable. It is incumbent upon all of us to let them know that.

— Carmela