Hospital groups have charged that the cuts would continue even through 2025 when the enhanced subsidies expire. RELATED: Contentious report suggests safety net hospitals leveraging discounts to pocket strong gains from cancer drugs The legislation is part of a larger $1.75 trillion spending package expected to be considered in the coming weeks.īut to offset the costs for closing the Medicaid coverage gap, lawmakers included $444 million in DSH payment cuts to nonexpansion state hospitals, which reimburse them for treating uncompensated care. Residents who would be eligible for Medicaid had the state expanded could get the subsidies and buy coverage on the ACA exchanges. Democrats in the House released legislation last week that would create new federal subsidies available to people in states that have not expanded Medicaid under the Affordable Care Act (ACA).