Sending Office: Honorable Eliot L. Engel
Sent By:

Keep Safety Net Hospitals Open: Ask Leadership to Delay Cuts to Medicaid DSH Payments

DEADLINE: Wednesday, September 20th at 12PM

Current signers: Eliot L. Engel, John A. Culberson, Steven M. Palazzo, Bobby L. Rush, Yvette D. Clarke, Joseph P. Kennedy, III, Paul D. Tonko, John Lewis, Nita M. Lowey, Brian Higgins, Diana DeGette, Jacky Rosen,
Elise Stefanik, Tom Cole, Joseph Crowley, Jerrold Nadler, Peter T. King, Jodey Arrington, Robert Aderholt, Grace Meng,
Mike D. Rogers, John Garamendi, Nydia Velázquez, Dutch Ruppersberger, José E. Serrano, Tim Ryan, Gwen Moore, Katherine Clark,
Blake Farenthold, Michael McCaul, Jan Schakowsky.

Dear Colleague,

Please join a bipartisan letter to Congressional leaders requesting a delay to harmful Medicaid Disproportionate Share Hospital (DSH) cuts.

Medicaid DSH payments are critical to the hospitals that serve our nation’s most vulnerable citizens. In treating a disproportionate number of low-income and uninsured patients, these hospitals incur tremendous uncompensated costs. Medicaid DSH payments
help to make up for those losses, allowing our communities’ hospitals to keep their doors open.

Hospitals’ ability to serve our constituents may be in jeopardy if the scheduled Medicaid DSH cuts are not delayed before October 1.

Congress has already recognized the dangers posed by cuts to Medicaid DSH payments, and has delayed the cuts on a bipartisan basis. We must again work together to keep hospitals’ doors open for our constituents. Please join us in asking Congressional leaders
to delay cuts to Medicaid DSH payments for at least two years, or until a more sustainable, permanent solution is reached.

If you would like to sign this letter, or have any questions, please reach out to
Catherine Rowland (Engel),
Alycia Maloney
(Culberson) or
Colleen Kennedy

Thank you for your consideration.


Eliot L. Engel

Member of Congress

John A. Culberson

Member of Congress

Steven M. Palazzo

Member of Congress


September XX, 2017

Dear Speaker Ryan and Leader Pelosi,

We write to express our serious concerns regarding the impact of impending cuts to Medicaid Disproportionate Share Hospital (DSH) payments, scheduled to take effect on October 1, 2017. Medicaid DSH payments allow hospitals nationwide to treat our most vulnerable
Americans. We urge you to take swift action to delay these harmful cuts for at least two years.

President Ronald Reagan and Congress created Medicaid DSH payments to sustain hospitals that serve a disproportionate number of low-income and uninsured patients. In treating those who have nowhere else to turn, these hospitals incur substantial uncompensated
costs. Furthermore, these same hospitals typically operate on very narrow, or even negative, margins. Medicaid DSH payments allow them to continue serving our constituents. Medicaid DSH payments not only support hospitals in cities across the country, these
payments are also especially important to rural hospitals, which often face added financial burdens.

Through bipartisan efforts, Congress has repeatedly recognized the importance of Medicaid DSH payments, and passed legislation to delay cuts to the program:

  • The Bipartisan Budget Act of 2013 delayed the cuts, scheduled to begin in Fiscal Year (FY) 2014, for two years until FY 2016;
  • The Protecting Access to Medicare Act of 2014 delayed the FY 2016 reduction; and
  • The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) delayed the scheduled FY 2017 cuts by one additional year.

Should Congress fail to delay the cuts scheduled to begin on October 1, safety net hospitals will face a financial shortfall of $2 billion in FY 2018. These cuts will grow to $8 billion by 2024. Our nation’s hospitals cannot sustain losses of this magnitude.
Institutions will be forced to shutter, leaving our constituents without a safety net.  

We ask that you work swiftly to delay these cuts for at least two fiscal years, through 2020, or until a more sustainable, permanent solution is reached. This delay will ensure that hospitals can keep their doors open and, most importantly, continue to care
for the most vulnerable among us. 

Thank you for your consideration. We look forward to your response.


Eliot L. Engel                                      John A. Culberson                              Steven M. Palazzo

Member of Congress                          Member of Congress                          Member of Congress


The Honorable Kevin McCarthy, House Majority Leader

The Honorable Steny Hoyer, House Minority Whip

The Honorable Mitch McConnell, Senate Majority Leader

The Honorable Charles Schumer, Senate Minority Leader

The Honorable Greg Walden, Chairman, Committee on Energy and Commerce

The Honorable Frank Pallone, Jr., Ranking Member, Committee on Energy and Commerce

The Honorable Orrin Hatch, Chairman, Senate Committee on Finance

The Honorable Ron Wyden, Ranking Member, Senate Committee on Finance

Related Legislative Issues

Selected legislative information: HealthCare

icon eDC logo e-Dear Colleague version 2.0