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The Medicaid Disproportionate Share Hospital (DSH) Program Supports Hospitals Serving A High Volume Of Low-Income & Uninsured Patients; Program Is Scheduled To Be Slashed By $4 Billion This Month, With No State Facing Greater Losses Than New York

With Lewis County General Hospital Set To Lose +$6M The Next Decade, Schumer Urges Congress To Prevent Cuts From Going Into Effect

Schumer: DSH Cuts Would Cripple Care In The North Country And Must Be Stopped

Standing at Lewis County General Hospital (LCGH),  the county’s largest employer, and flanked by advocates and public health experts, U.S. Senator Charles E. Schumer today sounded the alarm on devastating cuts to the Medicaid Disproportionate Share Hospital (DSH) program slated to go into effect this coming October. The Medicaid DSH program was designed to help hospitals that serve a high number of low-income and uninsured patients. As hospitals often receive either low reimbursement or no payment at all for treating those patients, the Medicaid DSH program helps provide hospitals with the financial flexibility to still offer world-class treatment to patients, regardless of who those patients are. Schumer explained that the Medicaid DSH program is set to be slashed by $4 billion on October 1st, 2019, which would cripple hospitals across the North Country, like LCGH, by severely restricting budgets and leading to the potential reduction of services and layoffs. Under the cuts, no state stands to lose more funding than New York, with projected losses of more than $7 billion over the next decade. Therefore, Schumer called on his colleagues in Congress to act immediately to stop the Medicaid DSH cuts, to ensure that LCGH and other hospitals across the region can continue providing first-rate care to all of their patients.

“Hospitals like Lewis County General Hospital operate on razor-thin margins, with every single dollar making a huge difference. They know this hospital is a lifeline to the community, and do their work because they believe that everyone deserves access to world-class health care, no matter how much money they have or where they come from. At a time when we need to be expanding access to medical services in the North Country, threatening hospitals with such a substantial cut is fundamentally wrong,” said Senator Schumer. “However, I have stopped these scheduled cuts before, and am now vowing to again. I am sending a message to my colleagues in Congress, loud and clear: I will not accept any proposal that hurts Upstate New Yorkers’ access to health care, and will fight tooth and nail to make sure these cuts are stopped.”

“If allowed to take effect, the impending Medicaid DSH cuts would place a tremendous strain on safety net hospitals that care for our most vulnerable populations,” said HANYS President Bea Grause, RN, JD. “We applaud Senator Schumer for his steadfast commitment to averting these massive reductions and continue to join him in his efforts to protect New York’s hospitals and health systems and the patients they serve.”

“The looming Medicaid DSH cuts would severely harm our safety net hospitals and the patients they serve,” said Greater New York Hospital Association President Kenneth E. Raske. “Every dollar counts, and these cuts would force some struggling hospitals to cut services, lay off staff, and even close their doors for good. New York’s hospitals are extremely grateful to Senator Schumer for his outstanding leadership on this critical issue.”

Schumer said that the North Country would be particularly damaged by the Medicaid DSH cuts. Below appears the Health Care Association of New York State’s (HANYS) projected losses for hospitals in the North Country should they be allowed to take effect.

  • Under the Medicaid DSH cuts,
    • Lewis County General Hospital stands to lose $6,164,400 over the coming decade.
    • Gouverneur Hospital stands to lose $1,139,600 over the coming decade.
    • Massena Memorial Hospital stands to lose $4,335,700 over the coming decade.
    • Claxton-Hepburn Medical Center stands to lose $1,640,100 over the coming decade.
    • Canton-Potsdam Hospital stands to lose $440,500 over the coming decade.
    • Clifton-Fine Hospital stands to lose $524,000 over the coming decade.
    • Carthage Area Hospital stands to lose $1,195,700 over the coming decade.
    • Samaritan Medical Center stands to lose $5,583,000 over the coming decade.
    • River Hospital stands to lose $1,246,300 over the coming decade. 

Schumer highlighted that the projected losses for LCGH are the highest of any hospital in the Jefferson-St Lawrence-Lewis County region. LCGH is the top employer in Lewis County, employing nearly 700 employees and having an economic impact of $114 million. Should Congress not delay the cuts, they could force LCGH to reduce services, hurt its ability to recruit doctors, delay capital improvements and even force layoffs. For example, LCGH is the main primary care provider in Lewis County and recently committed to expanding access to primary care in Copenhagen, NY. But because LCGH subsidizes primary care access and operates the service line at a deficit, the DSH cuts would jeopardize its ability to continue offering primary care to all regions of Lewis County. Additionally, LCGH is one of two Critical Access Hospitals (CAH) in New York State that offer OB/GYN service and is close to adding a second female OB/GYN doctor. Again, the DSH cuts could hurt LCGH’s ability to subsidize this program and could leave the county without reasonable access to OB/GYN services. Other specific departments that would be vulnerable should these cuts go into effect include adult day care, sleep lab, audiology, home health and hospice. Schumer added that these are all services that actually help reduce hospital utilization and add value.

Medicaid DSH adjustment payments provide additional help to hospitals that serve a significantly disproportionate number of low-income patients, with eligible hospitals being referred to as DSH hospitals. States receive an annual DSH allotment to cover the costs of the DSH hospitals that provide care to low-income patients. In 2018, the Medicaid DSH program provided roughly $3.6 billion to hospitals across New York State, a significantly higher total than any other state.

Schumer explained that the payments hospitals receive under the Medicaid DSH program are scheduled to be dramatically slashed this October unless Congress acts. HANYS projects that if allowed to stand, the cuts will lead to a loss of 75% in federal Medicaid DSH support to New York State hospitals. Therefore, Schumer argued that at a time when the people of the North Country need greater access to high-quality medical care, the last thing that Congress should be doing is cutting reimbursement to hospitals with a high volume of underserved patients, and called on his colleagues in Congress to expediently pass an extension of current Medicaid DSH funding levels.