Senate Finance Committee Markup Continues. Please Ask Your Senator to Support Schumer DSH Amendments - September 28, 2009

The Senate Finance Committee recessed today without finishing its markup of health reform legislation. The Committee has been considering amendments all week, and the markup is expected to resume Tuesday and run through most of next week.

Senator Schumer (D-NY) has not yet offered two Disproportionate Share Hospital (DSH) amendments, which would reduce cuts to the Medicaid and Medicare DSH programs to the levels in the House reform bill. In his mark, Chairman Baucus (D-MT) has $25 billion in Medicaid DSH cuts and $23 billion in Medicare DSH cuts; the Schumer amendments would reduce these cuts to $10 billion in each program. While NAPH has been working hard to urge senators to support these amendments, senators are under significant pressure not to offer amendments that would alter the funding for the bill. If you have a senator on the Finance Committee, please contact that senator to ask Sen. Schumer to introduce his Medicaid and Medicare DSH amendments and to support the amendments when they are introduced – see talking points. If you do not have a senator on the Finance committee, please ask your senator to encourage Sen. Schumer to introduce his DSH amendments and contact Chairman Baucus regarding the need to reduce the size of the DSH cuts proposed in the Senate legislation.

The Schumer Medicaid DSH amendment would also create two triggers before DSH cuts would take effect—one which is based on the percentage reduction in the uninsured and a second trigger which includes uncompensated care. NAPH has been advocating that Medicaid DSH supports Medicaid underpayments in addition to the costs of uninsured care, and supports a trigger that reflects Medicaid payment shortfalls, which would worsen with the substantial Medicaid expansion in the legislation.

Senator Hatch (R-UT) offered and then withdrew an amendment that would have eliminated the Medicaid DSH cuts altogether at the markup on Wednesday evening. Several senators, including Senators Snowe (R-ME) and Stabenow (D-MI), spoke in support of the need for DSH for underpayments.

We will keep you apprised of any further developments next week regarding the Senate Finance markup. Once the Finance Committee completes its work, the Senate is expected to take several weeks to merge the legislation from the Senate Finance Committee and the Health, Education, Labor and Pensions (HELP) Committee before a floor vote in the Senate.