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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

MACPAC Meets to Discuss Medicaid DSH Policy and Future of CHIP

September 16, 2016—The Medicaid and CHIP Payment and Access Commission (MACPAC) Sept. 15 met to discuss Medicaid disproportional share hospital (DSH) policy, as well as possible recommendations on the future of the Children’s Health Insurance Program (CHIP). 

The commission examined preliminary effects of Medicaid expansion under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152) on uncompensated care and Medicaid Disproportionate Share Hospital (DSH) payments. As states that have expanded Medicaid have higher Medicaid utilization rates, the commission discussed whether state Medicaid expansions should affect state DSH allotments to hospitals. Commissioners stated that the complexity of Medicaid DSH allotments make targeting payments at the state and provider level challenging, but agreed that the issue should be further explored in the future. 

The commission also reviewed its previous recommendations to extend CHIP and discussed potential options for future recommendations on the program. Commission staff presented several draft recommendation elements for commissioners, including: extend CHIP funding for five years through fiscal year (FY) 2022; permit optional, CHIP-funded exchange subsidies; broaden state innovation waivers; and extend expiring provisions through FY 2022, including express lane eligibility authority for children in Medicaid and CHIP, funding for outreach and enrollment grants, and funding for pediatric quality measures. Commissioners will vote on these recommendations during their December meeting.


Ayeisha Cox, J.D.
Hospital Policy & Regulatory Specialist
Telephone: 202-282-0482

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806


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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806