States ranked by annual Medicaid DSH payments

New York spends the most on Medicaid disproportionate share hospital payments annually, according to data published in November by KFF.

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By: Jakob Emerson

The data includes adjustments to spending in prior years. In some instances where spending is near zero, spending may be in another category such as managed care. The data was sourced from Urban Institute estimates based on data from CMS, as of September 2023. Total U.S. DSH payments were $17.9 billion.

States ranked by annual Medicaid DSH payments:

  1. New York: $3.9 billion
  2. Texas: $1.9 billion
  3. Pennsylvania: $1.2 billion
  4. Louisiana: $1.2 billion
  5. New Jersey: $928.2 million
  6. Missouri: $835.2 million
  7. Michigan: $608.6 million
  8. Illinois: $597.3 million
  9. California: $595.8 million
  10. South Carolina: $592.2 million
  11. Indiana: $578.1 million
  12. Georgia: $564.2 million
  13. North Carolina: $462 million
  14. Washington: $377.1 million
  15. Florida: $368 million
  16. Alabama: $312 million
  17. Mississippi: $245.7 million
  18. New Hampshire: $245.5 million
  19. Ohio: $211 million
  20. Colorado: $210.1 million
  21. Maryland: $197.9 million
  22. Connecticut: $184.7 million
  23. Rhode Island: $160 million
  24. Arizona: $155.6 million
  25. Nevada: $144.9 million
  26. Wisconsin: $143.1 million
  27. District of Columbia: $125.2 million
  28. West Virginia: $90.2 million
  29. Oregon: $89.3 million
  30. Kansas: $83.6 million
  31. Tennessee: $71.9 million
  32. Oklahoma: $64.9 million
  33. Maine: $58.5 million
  34. Minnesota: $50.3 million
  35. Kentucky: $49.2 million
  36. Vermont: $46.4 million
  37. Delaware: $42.7 million
  38. Virginia: $42.3 million
  39. Nebraska: $39.9 million
  40. Utah: $34.7 million
  41. New Mexico: $33.6 million
  42. Idaho: $27.8 million
  43. Arkansas: $26.6 million
  44. Alaska: $11 million
  45. Iowa: $10 million
  46. North Dakota: $1.8 million
  47. South Dakota: $1.7 million
  48. Wyoming: $473,090
  49. Hawaii: $0
  50. Massachusetts: $0
  51. Montana: $0

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