The proposed Medicaid Public Provider Cost Limit Rule would result in devastating cuts to safety net hospitals because it eliminates or limits how states may finance the non-federal share of disproportionate share hospital (DSH) payments and other supplemental payments. The rule was finalized by the Bush Administration, but the final rule was invalidated and returned to its proposed status by a judge in Alameda County Medical Center v. Leavitt, brought by the named plaintiff, NAPH, and other national hospital organizations. NAPH has asked the Obama Administration to withdraw the proposed provider cost limit rule.