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This bill would set a floor for federal Medicaid payments that help hospitals care for low-income and uninsured patients. Right now, each state gets a Medicaid “disproportionate share hospital” allotment, but this bill says no state could receive less than a certain minimum amount. The goal is to support hospitals, especially in rural areas, by making sure state allotments do not fall too low after 2024.
- For fiscal years 2025 through 2029, every state would receive at least $20 million in Medicaid disproportionate share hospital funding.
- Beginning in fiscal year 2030, that minimum amount would continue from the prior year and grow each year based on inflation.
- The new minimum would apply even if other parts of current law would otherwise reduce a state’s allotment.
Official Summaries
Fair Funding for Rural Hospitals Act
This bill establishes a minimum funding allotment for Medicaid disproportionate-share hospitals (DSHs). (DSHs are hospitals that receive additional payments under Medicaid for treating a large share of low-income patients.)
Specifically, the bill establishes a minimum allotment of $20 million per state for FY2025-FY2029, increased for inflation in subsequent years, despite any required reductions or other applicable funding calculations.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 474 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 474
To amend title XIX of the Social Security Act to establish a minimum
Medicaid disproportionate share hospital allotment for States.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 6 (legislative day, February 5), 2025
Mr. Barrasso (for himself, Mr. Schatz, Mr. Cramer, and Mr. Welch)
introduced the following bill; which was read twice and referred to the
Committee on Finance
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to establish a minimum
Medicaid disproportionate share hospital allotment for States.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Fair Funding for Rural Hospitals
Act''.
SEC. 2. MINIMUM MEDICAID DSH ALLOTMENT.
Section 1923(f)(6) of the Social Security Act (42 U.S.C. 1396r-
4(f)(6)) is amended by adding at the end the following new
subparagraph:
``(C) Minimum dsh allotment for fiscal years after
2024.--
``(i) In general.--Notwithstanding the
table set forth in paragraph (2) or the
reductions required under paragraph (7), for
fiscal year 2025 and each succeeding fiscal
year, the DSH allotment for any State shall not
be less than the minimum DSH allotment amount
established for the fiscal year under clause
(ii).
``(ii) Minimum dsh allotment amount.--The
minimum DSH allotment amount established under
this clause--
``(I) for each of fiscal years 2025
through 2029, shall be equal to
$20,000,000; and
``(II) for fiscal year 2030 and
each succeeding fiscal year, shall be
equal to the minimum DSH allotment
amount established under this clause
for the preceding fiscal year, subject
to an increase for inflation as
provided in paragraph (3)(A).''.
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