Biden spending bill's proposed cuts to hospital funding draw scrutiny

House version of the bill includes a cut in payments to hospitals that serve Medicaid patients in 12 states

Republican Florida Sen. Rick Scott and other critics are pushing back on a portion of President Biden’s Build Back Better Act that would cut hospital funding across predominantly right-leaning states, according to a report Monday.

The House version of the bill includes a provision that would cut Disproportionate Share Hospital payments across 12 states that haven’t expanded Medicaid coverage. DSH payments support hospitals that serve large numbers of patients who utilize Medicaid or are uninsured.

It’s unclear if the provision will be included in the Senate’s version of the Build Back Better Act. Scott, a major critic of the proposal, told the Washington Times it would hurt low-income families as part of the same legislation that would restore tax deductions for wealthy blue state residents.

U.S. Sen. Rick Scott (R-FL) speaks during a news conference at the U.S. Capitol January 17, 2019 in Washington, DC. (Alex Wong/Getty Images)

"It doesn’t add up," Scott told outlet. "I just think that it’s evil. It’s mean-spirited. The Democrats are taking care of the people in New York or Illinois or Connecticut and taking advantage of the people in places like Florida or Texas."

Biden and other proponents of health care provisions included in the Build Back Better Act argue it will expand medical coverage for the uninsured. The White House touts its plan as "the biggest expansion of affordable health care in a decade." The plan is also seen as a push to incentivize holdout states to expand Medicaid.

Last month, Democratic Georgia Sens. Raphael Warnock and Jon Ossoff led a group of state lawmakers who penned a letter to congressional leadership asking for the cuts to be eliminated. Georgia is one of the 12 states that would be affected.

U.S. President Joe Biden answers reporters' questions after delivering closing remarks for the White House's virtual Summit For Democracy in the Eisenhower Executive Office Building on Dec. 10, 2021 in Washington, DC. (Chip Somodevilla/Getty Images / Getty Images)

"Reducing federal funds to hospitals and providers can be detrimental to their survival, and in the midst of a global pandemic, we should not be imposing additional financial constraints," the lawmakers said.

The Senate version of the Build Back Better Act is expected to include notable changes from the House’s version. Moderates, including Sen. Joe Manchin of West Virginia, have expressed concerns about various elements of the bill.

Updated bill text released by the Senate Finance Committee did not include cuts to Disproportionate Share Hospital payments included in the House version. The American Hospital Association is among the advocacy groups urging the cuts to be excluded from the final text.


Sen. Raphael Warnock (D-GA) speaks on Medicare expansion and the reconciliation package during a press conference with fellow lawmakers at the U.S. Capitol on Sept. 23, 2021 in Washington, DC. (Photo by Kevin Dietsch/Getty Images / Getty Images)

"As negotiations on the Build Back Better Act continue in the Senate, the AHA continues to advocate for the elimination of reductions in federal funding for uncompensated care pools," the AHA said in a statement.