Local Impact of Medicaid Disproportionate Share Hospital Payment Cuts

Under current law, all states' federal Medicaid DSH allotments will be reduced by $4 billion in federal fiscal year 2020 (beginning Oct. 1, 2019). Cuts will increase to $8 billion a year in fiscal years 2021 to 2025.

The cut to Texas hospitals will not be known until CMS publishes its final rule describing its methodology for distributing federal DSH allotment reductions. However, the Medicaid and CHIP Payment Access Commission estimates the reduction will be $450 million, or 22.8 percent of DSH payments, in 2020.

Texas hospitals support the repeal of DSH cuts or, at a minimum, a two-year delay.

A bipartisan DSH letter, co-led by Rep. Pete Olson (TX-22), to delay scheduled Medicaid DSH cuts for two years, was submitted to the House leadership in May. 

In addition to Rep. Olson,  29 members of the Texas Congressional delegation signed on to the letter (Reps. Allred, Arrington, Babin, Bernice Johnson, Carter, Castro, Cloud, Conaway, Crenshaw, Cuellar, Doggett, Escobar, Fletcher, Flores, Garcia, Gooden, Granger, Green, Gohmert, Gonzalez, Hurd, Jackson Lee, McCaul, Thornberry, Veasey, Vela, Weber, Williams and Wright). THA members are encouraged to thank these members for their support.

See how the DSH payment cuts under current law impact your Congressional district using the resources on this page.

Rep. Louie Gohmert (TX-1)
Rep. Daniel Crenshaw (TX-2)
Rep. Van Taylor (TX-3)
Rep. John Ratcliffe (TX-4)
Rep. Lance Gooden (TX-5)
Rep. Ronald Wright (TX-6)
Rep. Lizzie Pannill Fletcher (TX-7)
Rep. Kevin Brady (TX-8)
Rep. Al Green (TX-9)
Rep. Michael McCaul (TX-10)
Rep. Mike Conaway (TX-11)
Rep. Kay Granger (TX-12)
Rep. Mac Thornberry (TX-13)
Rep. Randy Weber (TX-14)
Rep. Vicente Gonzalez (TX-15)
Rep. Veronica Escobar (TX-16)
Rep. Bill Flores (TX-17)
Rep. Sheila Jackson Lee (TX-18)
Rep. Jodey Arrington (TX-19)
Rep. Joaquin Castro (TX-20)
Rep. Chip Roy (TX-21)
Rep. Pete Olson (TX-22)
Rep. Will Hurd (TX-23)
Rep. Kenny Marchant (TX-24)
Rep. Roger Williams (TX-25)
Rep. Michael Burgess (TX-26)
Rep. Michael Cloud (TX-27)
Rep. Henry Cuellar (TX-28)
Rep. Sylvia Garcia (TX-29)
Rep. Eddie Bernice Johnson (TX-30)
Rep. John Carter (TX-31)
Rep. Colin Allred (TX-32)
Rep. Marc Veasey (TX-33)
Rep. Filemon Vela (TX-34)
Rep. Lloyd Doggett (TX-35)
Rep. Brian Babin (TX-36)


Stephanie Limb, vice president, advocacy communications, 512/465-1557

Kate Hendrix, senior director, policy analysis, 512/465-1556

Letter to DSH
Engel-Olson Letter to DSH