States ranked by annual Medicaid DSH payments

By Jakob Emerson / November 8, 2023

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

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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States ranked by annual Medicaid managed care spend