AFI HEALTH COMMITTEE: ISSUES IN BRIEF
Federal Proposals on Medicaid Disproportionate Share
March 2000
AFI HEALTH COMMITE OFFICERS:
Chair: Representative Kathryn Bowers, Tennessee
Vice Chair: Representative Garnet Coleman, Texas
Vice Chair: Representative Mary McGrattan, Connecticut
Vice Chair: Senator Patricia Miller, Indiana
Background
The Balanced Budget Act of 1997 reduced federal spending for Medicaid Disproportionate Share Hospitals (DSH) by $10.4 billion over five years. The BBA created state-specific allotments for the five years (1998-2002). The allotments are hard caps with most of the reductions occurring during fiscal years 2000-2002. Starting in fiscal year 2003, the federal DSH payments may increase for each state by the change in the Consumer Price Index (CPI), but the growth would be subject to a ceiling of 12 percent of the state's annual Medicaid expenditures.
Thus far two bills have been introduced in the House of Representatives to preserve federal DSH dollars and prevent further reductions in the federal allotments. Because DSH payments are based on a formula, some states will benefit more than others under the proposed bills. NCSL will not take a position on the legislation, but wanted to make you aware of the legislation and will continue to provide updates as the bills move through Congress.
Legislation
H.R. 3698-Medicaid DSH Preservation Act of 2000; sponsored by Representative Edward Whitfield (R-Kentucky) and Representative Brian Bilbray (R-California)
- This bill would continue Medicaid DSH allotments to the states for fiscal years 2001 and 2002 at the FY 2000 levels.
- This bill would move up the CPI adjustment from 2003 to 2001.
H.R. 3710-Medicaid Safety Net Hospital Preservation Act of 2000; sponsored by Representative Diana DeGette (D-Colorado) and Representative Brian Bilbray (R-California)
- This bill would continue Medicaid DSH allotments to the states for fiscal years 2001 and 2002 at the FY 2000 levels.
Fiscal Impact Compared to BBA Allotments
H.R. 3698
|
State |
FY 00 Federal DSH Allotment |
BBA FY 01 Federal DSH Allotment |
H.R. 3698
FY 01 Federal DSH Allotment |
Potential Value of Change in 2001 |
Cumulative Potential Value of Change 2001-2005* |
|
Alabama |
248,000,000 |
246,000,000 |
248,794,607 |
2,794,607 |
40,227,345 |
|
Alaska |
10,000,000 |
9,000,000 |
10,250,000 |
1,250,000 |
7,504,727 |
|
Arizona |
81,000,000 |
81,000,000 |
83,025,000 |
2,025,000 |
19,052,909 |
|
Arkansas |
2,000,000 |
2,000,000 |
2,050,000 |
50,000 |
470,442 |
|
California |
986,000,000 |
931,000,000 |
1,010,650,000 |
79,650,000 |
739,552,211 |
|
Colorado |
79,000,000 |
74,000,000 |
80,975,000 |
6,975,000 |
44,345,045 |
|
Connecticut |
164,000,000 |
160,000,000 |
166,100,000 |
8,100,000 |
59,186,323 |
|
Delaware |
4,000,000 |
4,000,000 |
4,100,000 |
100,000 |
940,884 |
|
District of Columbia |
32,000,000 |
32,000,000 |
32,800,000 |
800,000 |
7,527,075 |
|
Florida |
197,000,000 |
188,000,000 |
201,925,000 |
13,925,000 |
208,981,636 |
|
Georgia |
241,000,000 |
228,000,000 |
247,025,000 |
19,025,000 |
177,653,692 |
|
Idaho |
1,000,000 |
1,000,000 |
1,025,000 |
25,000 |
235,221 |
|
Illinois |
193,000,000 |
182,000,000 |
197,825,000 |
15,825,000 |
143,600,501 |
|
Indiana |
191,000,000 |
181,000,000 |
195,775,000 |
14,775,000 |
137,977,543 |
|
Iowa |
8,000,000 |
8,000,000 |
8,200,000 |
200,000 |
1,881,769 |
|
Kansas |
42,000,000 |
36,000,000 |
43,050,000 |
7,050,000 |
53,251,927 |
|
Kentucky |
130,000,000 |
123,000,000 |
133,250,000 |
10,250,000 |
95,713,962 |
|
Louisiana |
713,000,000 |
658,000,000 |
713,000,000 |
55,000,000 |
383,000,000 |
|
Maine |
84,000,000 |
84,000,000 |
86,100,000 |
2,100,000 |
19,758,573 |
|
Maryland |
68,000,000 |
64,000,000 |
69,700,000 |
5,700,000 |
49,062,644 |
|
Massachusetts |
273,000,000 |
259,000,000 |
279,825,000 |
20,825,000 |
198,638,314 |
|
Michigan |
237,000,000 |
224,000,000 |
242,925,000 |
18,925,000 |
172,560,292 |
|
Minnesota |
33,000,000 |
33,000,000 |
33,825,000 |
825,000 |
7,762,296 |
|
Mississippi |
136,000,000 |
129,000,000 |
139,400,000 |
10,400,000 |
97,125,289 |
|
Montana |
200,000 |
200,000 |
205,000 |
5,000 |
47,044 |
|
Nebraska |
5,000,000 |
5,000,000 |
5,125,000 |
125,000 |
1,176,106 |
|
Nevada |
37,000,000 |
37,000,000 |
37,925,000 |
925,000 |
8,703,181 |
|
New Mexico |
9,000,000 |
9,000,000 |
9,225,000 |
225,000 |
2,116,990 |
|
New York |
1,436,000,000 |
1,361,000,000 |
1,471,900,000 |
110,900,000 |
1,039,807,364 |
|
North Carolina |
264,000,000 |
250,000,000 |
270,600,000 |
20,600,000 |
192,368,809 |
|
North Dakota |
1,000,000 |
1,000,000 |
1,025,000,000 |
25,000 |
235,221 |
|
Ohio |
363,000,000 |
344,000,000 |
372,075,000 |
28,075,000 |
262,180,854 |
|
Oklahoma |
16,000,000 |
16,000,000 |
16,400,000 |
400,000 |
3,763,538 |
|
Oregon |
20,000,000 |
20,000,000 |
20,500,000 |
500,000 |
4,704,422 |
|
Pennsylvania |
502,000,000 |
476,000,000 |
514,550,000 |
38,550,000 |
364,164,322 |
|
Rhode Island |
58,000,000 |
55,000,000 |
59,450,000 |
4,450,000 |
41,557,918 |
|
South Carolina |
262,000,000, |
262,000,000 |
262,000,000 |
--- |
27,198,977 |
|
South Dakota |
1,000,000 |
1,000,000 |
1,025,000 |
25,000 |
235,221 |
|
Texas |
806,000,000 |
765,000,000 |
826,150,000 |
61,150,000 |
400,841,350 |
|
Utah |
3,000,000 |
3,000,000 |
3,075,000 |
75,000 |
705,663 |
|
Vermont |
18,000,000 |
18,000,000 |
18,450,000 |
450,000 |
4,233,980 |
|
Virginia |
66,000,000 |
63,000,000 |
67,650,000 |
4,650,000 |
47,592,202 |
|
Washington |
166,000,000 |
157,000,000 |
170,150,000 |
13,150,000 |
122,791,984 |
|
West Virginia |
61,000,000 |
58,000,000 |
62,525,000 |
4,525,000 |
46,416,097 |
|
Wisconsin |
7,000,000 |
7,000,000 |
7,175,000 |
175,000 |
1,646,548 |
|
Wyoming |
100,000 |
100,000 |
102,500 |
2,500 |
23,522 |
*Note: CPI percentage for years 2001 through 2005 is assumed to be 2.5%
Medicaid growth for years 2001 through 2005 is assumed to be 8.6%
H.R. 3710
|
State |
FY 00 Federal DSH Allotment |
BBA FY 01 Federal DSH Allotment |
H.R. 3710
FY 01 Federal DSH Allotment |
Potential Value of Change in 2001 |
Cumulative Potential Value of Change 2001-2005* |
|
Alabama |
248,000,000 |
246,000,000 |
248,000,000 |
2,000,000 |
10,305,031 |
|
Alaska |
10,000,000 |
9,000,000 |
10,000,000 |
1,000,000 |
5,152,516 |
|
California |
986,000,000 |
931,000,000 |
986,000,000 |
55,000,000 |
507,624,203 |
|
Colorado |
79,000,000 |
74,000,000 |
79,000,000 |
5,000,000 |
25,762,578 |
|
Connecticut |
164,000,000 |
160,000,000 |
164,000,000 |
4,000,000 |
20,610,062 |
|
Florida |
197,000,000 |
188,000,000 |
197,000,000 |
9,000,000 |
162,643,078 |
|
Georgia |
241,000,000 |
228,000,000 |
241,000,000 |
13,000,000 |
120,965,406 |
|
Illinois |
193,000,000 |
182,000,000 |
193,000,000 |
11,000,000 |
98,202,828 |
|
Indiana |
191,000,000 |
181,000,000 |
191,000,000 |
10,000,000 |
93,050,313 |
|
Kansas |
42,000,000 |
36,000,000 |
42,000,000 |
6,000,000 |
43,372,641 |
|
Kentucky |
130,000,000 |
123,000,000 |
130,000,000 |
7,000,000 |
65,135,219 |
|
Louisiana |
713,000,000 |
658,000,000 |
713,000,000 |
55,000,000 |
383,000,000 |
|
Maryland |
68,000,000 |
64,000,000 |
68,000,000 |
4,000,000 |
33,067,609 |
|
Massachusetts |
273,000,000 |
259,000,000 |
273,000,000 |
14,000,000 |
134,422,953 |
|
Michigan |
237,000,000 |
224,000,000 |
237,000,000 |
13,000,000 |
116,812,891 |
|
Mississippi |
136,000,000 |
129,000,000 |
136,000,000 |
7,000,000 |
65,135,219 |
|
New York |
1,436,000,000 |
1,361,000,000 |
1,436,000,000 |
75,000,000 |
702,029,859 |
|
North Carolina |
264,000,000 |
250,000,000 |
264,000,000 |
14,000,000 |
130,270,438 |
|
Ohio |
363,000,000 |
344,000,000 |
363,000,000 |
19,000,000 |
176,795,594 |
|
Pennsylvania |
502,000,000 |
476,000,000 |
502,000,000 |
26,000,000 |
246,083,328 |
|
Rhode Island |
58,000,000 |
55,000,000 |
58,000,000 |
3,000,000 |
27,915,094 |
|
Texas |
806,000,000 |
765,000,000 |
806,000,000 |
41,000,000 |
211,253,141 |
|
Virginia |
66,000,000 |
63,000,000 |
66,000,000 |
3,000,000 |
32,067,609 |
|
Washington |
166,000,000 |
157,000,000 |
166,000,000 |
9,000,000 |
83,745,281 |
|
West Virginia |
61,000,000 |
58,000,000 |
61,000,000 |
3,000,000 |
32,067,609 |
*Note: CPI percentage for years 2001 through 2005 is assumed to be 2.5%
Medicaid growth for years 2001 through 2005 is assumed to be 8.6%
**Tables prepared by American Hospital Association.
|
