Sen. Rick Scott to House Members: Charity Hospitals Face Huge Cuts in Reckless “Build Back Better” Plan; Don’t Support it

November 5, 2021

WASHINGTON, D.C. – Today, the House of Representatives is considering President Biden’s nearly $4 TRILLION tax-and-spending spree package. This deeply flawed bill raises taxes on American families while giving a huge SALT tax cut to the rich Democrat donors and failed politicians in liberal states like New York and California, fuels a raging inflation crisis and makes massive cuts to charity hospitals in states, like Florida, which have rejected the disaster of Obamacare and not expanded Medicaid. Given this disastrous decision by House Democrats to cut funding for charity hospitals to treat the underserved and uninsured, Senator Rick Scott wrote to House members representing the impacted states of Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming urging them to vote against this reckless spending bill.


Read more in the letter HERE or below.


 November 5, 2021


Dear Colleague:


I write to you today with grave concern that President Joe Biden’s “Build Back Better” plan not only raises taxes on millions of American families and businesses and further fuels our nation’s raging inflation crisis – it also harshly punishes charity hospitals that provide care to those most in need.


Section 30608 of the “Build Back Better” bill put forward by Democrats in the House of Representatives would cut 12.5% from Disproportionate Share Hospital Payments (DSH) and reduce payments from states’ Uncompensated Care Pool (UCP). I want to be very clear: what I have just described are massive cuts to Medicaid, supported by Speaker Pelosi and top House Democrats, squarely targeted at non-expansion states, which you represent.


The table below reflects an estimate from the non-partisan Medicaid and CHIP Payment and Access Commission (MEDPAC), which shows the annual DSH cuts that will occur from these misguided policies.



Current Federal DSH (in millions)

Proposed Reduction (in millions)
















North Carolina



South Carolina



South Dakota



















Our states will see a cut of over $4.2 billion in the next decade to charity hospitals whose work is predominately focused on treating the underserved and uninsured.


While House Democrats’ proposed reduction to our states’ UCP is a harder figure to estimate, it will affect Florida, Kansas, Tennessee and Texas. This funding is typically negotiated between the Centers for Medicare and Medicaid Services (CMS) and the state under a budget-neutral 1115 waiver. To be clear, any cuts to these programs will only serve to hurt charity hospitals providing care to the poorest families.


Making drastic cuts to these valued and incredibly important programs defies reason. House Democrats are choosing to impose needless cuts which would hurt charity hospitals and harm the poor.


I urge you to act now to stop this flawed policy from moving forward and causing immense damage to the states and families we represent.





Rick Scott

U.S. Senator