Harshbarger, TN Colleagues Introduce House Companion Bill to Secure Permanent Hospital Support and Protect Care for Low-Income Patients

WASHINGTON, D.C. - Yesterday, Congresswoman Diana Harshbarger (R-TN) introduced the Delivering Support for Hospitals in Tennessee Act or the " DSH in Tennessee Act " ( H.R. 6393 ), a House companion bill to legislation U.S. Senators Marsha Blackburn and Bill Hagerty introduced this week ( S.3299 ). The landmark legislation would finally provide Tennessee with a permanent, modernized Disproportionate Share Hospital (DSH) allotment. Original House cosponsors include Tennessee Reps. Chuck Fleischmann, Scott DesJarlais, David Kustoff, John Rose, Tim Burchett, and Steve Cohen.

"For too long, Tennessee has been the only state in the nation forced to operate without a stable, permanent DSH allotment. That uncertainty has put tremendous strain on hospitals that serve our most vulnerable neighbors, especially rural providers. This bill finally ends the patchwork approach and delivers the long-term clarity and predictability Tennessee hospitals deserve." - Congresswoman Diana Harshbarger

Additionally, The DSH in Tennessee Act has the support of The Tennessee Hospital Association.

"Medicaid DSH provides critical funding to hospitals treating large numbers of low-income patients. These funds help offset hospitals' uncompensated care costs and improve access for Medicaid and uninsured patients. Unfortunately, Tennessee is at a unique disadvantage as the only state without a permanent Medicaid DSH allotment, and the state's most recent short-term appropriation expired in October, but has now been extended through January 30, 2026 as part of the continuing resolution package passed by Congress in November. The Tennessee Hospital Association appreciates the strong, bipartisan support from the Tennessee delegation to secure temporary, partial DSH payments for over two decades. The Delivering Support for Hospitals (DSH) in Tennessee Ac t will bring Tennessee hospitals back into statute and help provide relief and long-term certainty that hospitals in other states enjoy. On behalf of hospitals across Tennessee, THA applauds Senator Blackburn's and Rep. Harshbarger's leadership on, and appreciates the delegation's strong support of, legislation to achieve a permanent solution and ensure Tennessee hospitals will receive this critical funding in the future." - Dr. Wendy Long, President and CEO, Tennessee Hospital Association

BACKGROUND:

Senators Blackburn and Hagerty introduced the companion bill ( S. 3299 ) on December 2, reinforcing a unified Tennessee delegation effort to secure this long-overdue fix.

The legislation directly addresses Tennessee's long-standing structural disadvantage under federal law by:

• Establishing a permanent DSH allotment for Tennessee beginning in FY 2026, ending years of reliance on short-term carveouts, CRs, and temporary health extenders.
• Modernizing the allotment to reflect real-world costs-raising Tennessee's DSH amount from $53.1 million (set in 2015) to $72.9 million for FY 2026.
• Ensuring the allotment keeps pace with healthcare inflation by applying an automatic annual CPI-U adjustment so hospitals aren't forced to absorb rising costs year after year.

Together, these reforms replace instability with a predictable, long-term federal commitment, particularly important for hospitals that treat high numbers of low-income patients and depend on DSH support to remain operational.

Unlike every other state, Tennessee has never had a permanent DSH authorization. The result has been a decade of stop-gap funding measures that create uncertainty for hospital administrators, limit long-term planning, and make it harder for rural and safety-net hospitals to maintain services.

The DSH in Tennessee Act would finally corrects this imbalance by giving Tennessee the same stability other states enjoy while updating the allotment to reflect today's economic and healthcare realities.