Moody''s Investors Service: Hospitals In States That Refuse Medicaid Expansion Will Be Strained

Moody's Warns Of Trouble For Hospitals Without Medicaid Expansion by Elise Viebeck.  The Hill.  March 15, 2013.

By 2019, DSH (disproportionate share) fund payments to hospitals  will decline by $17 billion.  These funds  are aimed at helping hospitals to fund charity care.  Under Obamacare these funds are slated to decline because, under the law as originally written, the DSH funds lost would be replaced by payments from the newly insured under Medicaid.  With the ruling of the Supreme Court that Medicaid is optional for the states, this financing arrangement will not apply in states that do not accept Medicaid expansion, thus straining hospital and state financing.