December 3, 2025
Mrs. Harshbarger (for herself, Mr. Fleischmann, Mr. DesJarlais, Mr. Kustoff, Mr. Burchett, Mr. Rose, and Mr. Cohen) introduced the following bill; which was referred to the Committee on Energy and Commerce
To amend title XIX of the Social Security Act to provide a permanent disproportionate share hospital allotment to Tennessee for fiscal year 2026 and succeeding fiscal years, and for other purposes.
Section 1. Short title
This Act may be cited as the Delivering Support for Hospitals in Tennessee Act
or the DSH in Tennessee Act
.
Sec. 2. Permanent Tennessee DSH allotment for fiscal year 2026 and succeeding fiscal years
Section 1923(f)(3) of the Social Security Act (42 U.S.C. 1396r–4(f)(3)) is amended—
(1)
in subparagraph (A), by striking subparagraphs (E) and (F)
and inserting subparagraphs (E), (F), and (G)
; and
(2)
by adding at the end the following new subparagraph:
(G) Tennessee DSH restoration
(i) In general
Notwithstanding any other provision of this subsection, the State of Tennessee shall receive a DSH allotment under this paragraph beginning with fiscal year 2026 and for each succeeding fiscal year.
(ii) Allotment for fiscal year 2026
Notwithstanding the table set forth in paragraph (2) or the terms of the TennCare Demonstration Project in effect for the State, the DSH allotment for Tennessee for fiscal year 2026, shall be equal to the DSH allotment for Tennessee under paragraph (6)(A)(vi) for fiscal year 2015, increased in each succeeding fiscal year by the percentage change in the consumer price index for all urban consumers (all items; U.S. city average).
(iii) Treatment as a low DSH state
For any fiscal year after fiscal year 2026—
(I)
Tennessee shall be deemed to be a State described in paragraph (5)(B); and
(II)
the DSH allotment for Tennessee shall be the DSH allotment for the previous fiscal year increased in the same manner as DSH allotments for low DSH States are increased for such fiscal year under clause (iii) of such paragraph.