Without the DSH payments, hospitals will still be legally required to provide hospital treatment for these low-income patients. However, the hospitals won't get any Medicaid reimbursement for treating these patients because the people won't be in Medicaid — neither the higher reimbursement DSH payments that hospitals had received nor even regular Medicaid reimbursements for hospital care.
Without DSH, the state will also be in trouble. Lost DSH payments are huge. Without DSH payments, Oklahoma will lose about $49 million of its Medicaid budget per year.
This is a train wreck waiting to happen — for low-income patients and the hospitals. The bottom lines seem clear: Expand Medicaid for the 470,000 poorest citizens, get a terrific rate of return and avoid a hospital disaster.
Gold is an attorney in Philadelphia who has brought numerous lawsuits related to Medicaid and to the Americans with Disabilities Act.