Hospitals across the country are concerned about the degree to which the Affordable Care Act is reducing the Medicare disproportionate share hospital (Medicare DSH) payments that help underwrite the cost of the care they provide to uninsured patients.

Those in states that have expanded their Medicaid programs are now receiving payments for at least some of those formerly uninsured patients because those individuals are now enrolled in Medicaid. In states that did not expand their Medicaid programs, however, hospitals face challenges coming from two directions: reduced Medicare DSH payments without the benefit of some of those uninsured patients enrolling in Medicaid.

The state of Louisiana has not expanded its Medicaid program, and now, policy-makers there are faced with the question of how to finance their unexpanded Medicaid program in the face of reduced – and falling – Medicare DSH revenue.

The National Association of Urban Hospitals has long opposed the Affordable Care Act’s Medicare DSH cuts and has called on Congress to delay or repeal them.

Read more about the challenges that state faces and the role of Medicare DSH cuts in those challenges in this article from the Times-Picayune.