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.

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