MACPAC discusses Medicaid DSH cuts, provider taxes, redeterminations

At its December meeting this week, the Medicaid and CHIP Payment and Access Commission expressed concern about the financial viability of Medicaid Disproportionate Share Hospitals if Congress fails to delay cuts scheduled to take effect Jan. 19, with staff reporting an even lower average operating margin for deemed DSH hospitals (–4.6%) than hospitals overall (–0.8). Among other topics, the commission expressed concern about a lack of transparency around the role of provider taxes in financing the state share of Medicaid spending, an issue the commission is expected to address with recommendations in its June report to Congress. The commission also reviewed new data on Medicaid redeterminations since the end of the COVID-19 public health emergency, which show that half of the 27.3 million redeterminations since August resulted in renewal and 27% in disenrollment. Among the 7.5 million who have been disenrolled, 1.1 million people transitioned to exchange coverage, according to MACPAC staff.