The expansive $3.77 trillion budget proposed by President Obama folded in a small proposal that called for an increase in Medicaid spending by $360 million. The author purports that this is an admission that PPACA will not function as the president has claimed. Disproportionate share hospital (DSH) payments which are received by hospitals that treat large numbers of low income patients who cannot afford to pay for the services should not be needed for year 2014 if PPACA exchanges cover the 30 million uninsured they claim they will. Does the fact that Obama feels the DSH payments cannot be trimmed next year mean that he knows his law won’t work as planned?

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