As we have written previously, the manager’s amendment to the Senate bill that was adopted earlier today makes a number of changes to the Senate bill.
Our California Senator Barbara Boxer, as well as Senator Dianne Feinstein, won a significant improvement for California as well as six or seven other states, including Idaho, North Carolina and Michigan.
It is easy to figure out that Nebraska (and Hawaii) got something in the Medicaid provisions because those two states are mentioned by name.
We guessed that California met the following: “If the State is not a low DSH State described in (5) (B) and has spent more than 99.90 percent of the DSH allotments for the State on average for the period of fiscal years 2004 through 2008, as of September 30, 2009, the applicable percentage is 35 percent.”
What is that and why do we care? DSH or Disproportionate Share Hospital funding is a key part of Medicaid funding for hospitals. In some states, DSH helps to make up for low Medicaid reimbursement rates. In other states, including California, DSH helps to cover the cost of care by hospitals for the uninsured as well as improving low Medicaid rates.
DSH is a big deal in California both because we are 51st in Medicaid reimbursement and because we have such a high proportion of uninsured.
So what did our Senators win for us? The earlier version of the Senate bill cut DSH funding in half once the rate of uninsurance drops. The new version would cut DSH funding by only 35%.
This moves the Senate bill much closer to the House version in terms of the DSH cut, at least for California, Idaho, North Carolina, Michigan and several other states.