The Medicaid and CHIP Payment and Access Commission today released its March report to Congress, which includes an analysis of the effects of the Affordable Care Act on hospital uncompensated care. According to the report, total hospital uncompensated care for Medicaid and uninsured patients fell by $4.6 billion (9.3%) between 2013 and 2014, with the largest declines in states that expanded Medicaid. However, Disproportionate Share Hospitals in both expansion and non-expansion states continued to report negative operating margins before DSH payments. “While hospitals serving Medicaid and other low-income patients have benefited from gains in insurance coverage, many of these institutions, which serve as anchors of the health system in low-income communities, still face significant financial difficulties,” said MACPAC Chair Sara Rosenbaum. The commission said it will continue to monitor distribution of DSH payments across states and hospitals to understand how any changes in health insurance coverage for low-income families affect safety-net institutions. It also renewed its call for Congress to extend Children’s Health Insurance Program funding through 2022, among other recommendations for the program.