Issue Brief 17-22
August 17, 2017

The Affordable Care (ACA) reduced Medicaid Disproportionate Share Hospital (DSH) allotments on the assumption that there would be fewer uninsured people and less uncompensated care with the expansion of health care coverage. These cuts—initially scheduled to begin in fiscal year (FY) 2014—have been delayed repeatedly but are effective in FY 2018. On July 28, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that outlines the methodology for implementing the annual reductions, which total $2 billion in FY 2018.