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Washington, D.C. — U.S. Senators Marco Rubio (R-FL), Marsha Blackburn (R-TN), and colleagues sent a letter requesting that the Congressional Budget Office (CBO) disclose the impact President Joe Biden’s massive tax and spending bill will have on state Medicaid programs that support safety net hospitals, children’s hospitals, rural hospitals, and other Medicaid providers that care for low-income, uninsured, and underinsured beneficiaries. The Build Back Better Act includes a provision that would penalize states, such as Florida, by cutting millions in federal funding for Disproportionate Share Hospital (DSH) payments and Uncompensated Care Pools (UCP) funding.
 
“The Build Back Socialist bill is going to hurt Florida hospitals, especially those that treat low-income residents and the uninsured,” Rubio said. “It is reckless and irresponsible to cut the health care of some of our most vulnerable, including children, to pay for tax cuts for wealthy taxpayers in New York and California.” 
 
“In the Build Back Broke bill, Democrats have prioritized blue-state billionaires over sick children, people with disabilities, and the poor,” Blackburn said. “The sweeping federal overreach pushed by the Biden administration is a direct attempt to punish states like Tennessee providing personalized care for our vulnerable communities. The White House preaches the importance of empathy but is willing to strip care from Tennesseans to give their big-dollar donors tax breaks.”
 
Click here for a full list of quotes and Senators that signed the letter. 
 
The full text of the letter is below. 
 
Dear Dr. Swagel:
 
Thank you for your work to produce budgetary and economic analysis of the proposed legislation, the Build Back Better Act.
 
While the final text of the bill is not available at the time of this letter, we write today to ask for additional economic analysis of the legislation, specifically a section of the Energy & Commerce title which changes Medicaid Disproportionate Share Hospital (DSH) payment allotments as well as funding for Uncompensated Care Pools. This legislation would significantly affect states’ safety net programs and it is essential that each member of Congress have complete and full understanding of such a provision. In order to provide accurate information to our constituents who would be impacted by these punitive measures, we request your answers to the following questions:
 

1. What is the impact of this legislation on state budgets?
2. How would the DSH and Uncompensated Care Pool penalties impact coverage in the affected states?
3. What is the impact of this legislation to access to care, including closures, at safety net hospitals, children’s hospitals, and rural hospitals?
4. Does CBO believe that some individuals will have to go without care because of these DSH and Uncompensated Care Pool penalties?