[Congressional Record Volume 149, Number 43 (Tuesday, March 18, 2003)]
[Extensions of Remarks]
[Page E503]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    INTRODUCTION OF THE MEDICAID SAFETY NET IMPROVEMENT ACT OF 2003

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                         HON. GERALD D. KLECZKA

                              of wisconsin

                    in the house of representatives

                        Tuesday, March 18, 2003

  Mr. KLECZKA. Mr. Speaker, today Congresswoman Wilson and I are 
introducing the Medicaid Safety Net Improvement Act of 2003. This 
important legislation would increase the allowed federal Medicaid 
disproportionate share hospital (DSH) allotment in ``extremely low-
DSH'' states from one percent to three percent of Medicaid program 
costs.
  In the mid-1980s, Congress established the Medicaid DSH program to 
provide additional funds to certain hospitals that deliver a 
disproportionate share of health care services to low-income patients, 
including Medicaid recipients and the uninsured. By providing financial 
relief to these facilities, this program ensures that all Americans--
regardless of ability to pay--have access to critical hospital care.
  Unfortunately, due to limitations imposed by the Balanced Budget Act 
of 1997 (BBA) and the Medicare, Medicaid, and SCHIP Benefits 
Improvement and Protection Act of 2000 (BIPA), there are significant 
inequities in how these funds are distributed among states. For 18 
states, including the State of Wisconsin, the federal DSH allotments 
are not allowed to exceed one percent of the state's Medicaid program 
costs. The average state spends about eight percent of its Medicaid 
funding on DSH.
  This bipartisan legislation would address this inequity by raising 
the share of federal funds to extremely low-DSH states. The 18 states 
that would benefit from this proposal include: Alaska, Arkansas, 
Delaware, Idaho, Iowa, Kansas, Maryland, Minnesota, Montana, Nebraska, 
New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Utah, and 
Wyoming. It is important to note that this bill would not redistribute 
or reduce the federal DSH allotments in other states.
  The Medicaid DSH program plays a tremendous role in the survival of 
the safety net that serves our most vulnerable populations, 
particularly the rising number of uninsured Americans, which at last 
count stands at nearly 42 million. For many hospital facilities, 
Medicaid DSH is the main reason they are able to keep their doors open. 
Providing an increase to three percent of Medicaid spending in the 
allowable DSH allotment would do a great deal to help these low-DSH 
states support low-income medical care.
  I urge my colleagues to cosponsor and support this important 
legislation.




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