Medicaid State Directed Payments and Provider Taxes are Critical for Children’s Hospitals

Fact Sheet

Children's Hospital Association urges Congress to reject policies that would reduce Medicaid payments to children’s hospitals or restrict states’ use of provider taxes.

Published April 16, 2025 | 1 min. read

Congress is discussing potential reductions to states’ use of state directed payments (SDPs) and restrictions on how states can use provider taxes in efforts to reduce federal Medicaid expenditures.

SDPs are critical in ensuring access to care for the 37 million children covered by the Medicaid/CHIP program, especially at children’s hospitals. Provider taxes are used by states to finance their share of the Medicaid program. With children making up close to 50% of total Medicaid enrollees, even small adjustments in SDPs and/or states’ use of provider taxes would result in negative consequences for children covered by Medicaid, as well as the providers who care for them, including children’s hospitals.

Children's Hospital Association urges Congress to reject policies that would reduce Medicaid payments to children’s hospitals or restrict states’ use of provider taxes.

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