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Medicaid

Coverage and Delivery Reform

Medicaid, administered by states and jointly funded by states and the federal government, is the largest health insurance program in the United States, providing coverage to nearly one-in-four Americans – more than 72 million beneficiaries. As part of their missions, AAMC-member teaching hospitals and their physician faculty care for a disproportionate number of these patients, despite low Medicaid reimbursement rates. While representing 5% of the nation’s hospitals, major teaching hospitals account for 25% of all Medicaid hospital care and provide 31% of all charity care. Medicaid disproportionate share hospital (DSH) payments help alleviate some of this burden, but this funding is at risk. Unless Congress acts, Medicaid DSH funding will be cut by $4 billion in FY 2020 and increase to $8 billion per year between FY 2021-2025. Cuts of this magnitude would devastate the health care safety net.

Medicaid also plays a critical role in funding graduate medical education (GME). Though not mandatory, 42 states and Washington, DC, currently contribute to Medicaid GME to help offset the higher costs associated with training residents in teaching hospitals. This funding allows more physicians to be trained in teaching institutions, which improves not only the number of physicians, but also cultural competence, coordination between health care and community organizations, and access for Medicaid beneficiaries. Due to state budget shortfalls and Medicaid managed care organizations, there are serious concerns that less Medicaid funds will be available to train future physicians.


News and Updates


House Democratic Leaders Introduce Legislation to Reduce Prescription Drug Costs

September 20, 2019

House Democratic Leaders introduced a sweeping drug pricing bill aimed at lowering the cost of prescription drugs. 


House Passes CR to Fund Government Through Nov. 21

September 20, 2019

House passes continuing resolution, including extensions for health programs through Nov. 21, 2019.


Court of Appeals Issues Ruling on Counting Third-Party Payments in Medicaid DSH Definition

August 16, 2019

A federal appellate court issued an Aug. 13 decision on the treatment of third-party payments in the Medicaid disproportionate share hospital (DSH) shortfall definition.


DHS Issues Final Rule on “Public Charge”

August 14, 2019

The Department of Homeland Security (DHS) Aug. 12 released the “Inadmissibility on Public Charge Grounds” final rule to establish new standards about which public benefits will be considered when legal immigrants seek to change their immigration status or enter the United States. The final rule will be effective Oct. 15.


Senate Finance Committee Advances Legislation to Reduce Prescription Drug Costs

July 26, 2019

The Senate Finance Committee July 25 held a markup of the Prescription Drug Pricing Reduction Act of 2019 (PDPRA), a bipartisan proposal introduced by Committee Chair Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) to lower the price of prescription drugs.


On Government Affairs



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