Washington Bureau -Alex Cameron - August 10, 2023 6:45 am


A member of Oklahoma’s congressional delegation is helping lead an effort to spare hospitals in Oklahoma and across the country from a looming funding cut that could cause significant financial hardship.

The cut would be to the Medicaid DSH — Disproportionate Share Hospital — payments, a program that since 1981 has been helping hospitals that have disproportionately high numbers of Medicaid, uninsured and underinsured patients, offset the cost of uncompensated care.

“It has been a real lifeline to hospitals all across the state,” said Rich Rasmussen, President and CEO of the Oklahoma Hospital Association.

Rasmussen is relatively new to Oklahoma (he started at OHA in June) but has worked in the hospital management for decades and understands the importance of the DSH funding. He said just under half the hospitals in the state get some amount of DISH funding each year; the state’s total allotment for 2023 is about $90 million, the majority of it coming from Washington.

“If we end up having a DSH cut,” Rasmussen said in an interview Wednesday, “it’s going to create some pain that will trickle across the state.”

The scheduled $8 billion cut would mean Oklahoma hospitals would lose about $40 million over the next four years, impacting not just rural communities, but also some of the state’s largest hospitals.

“The larger the hospital and the more Medicaid and uninsured services that they provide,” Rasmussen noted, “the greater the pain.”

The cut is tied to the landmark Affordable Care Act and its original vision of universal health coverage, which, had it been realized, would have meant less need for the DISH payments.

But when the U.S. Supreme Court struck down the individual mandate, the notion of universal coverage became a state-by-state proposition.

“Everyone is hopeful that at some point we will get to a place where every state’s coverage is very equal,” he explained, “so that these intended, or anticipated, reductions have the opportunity to go forward, but we’re not there yet, unfortunately.”

And that’s meant Congress has had to step in before to stop the cuts from taking effect and it’s why Oklahoma Senator James Lankford and a bipartisan group of 50 other Senators sent a letter to leadership last week.

“Congress has acted in a bipartisan manner on multiple occasions over the last eleven years to avert the Medicaid DSH cuts,” they wrote. “We ask you to continue this effort and act before these reductions take place.”

A similar letter was sent to House leadership in May. Oklahoma Congressman Tom Cole (R-OK4) was among more than 200 signatories. Congress will be back in session to deal with this and other pending issues in September.


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