CHICAGO -- An association of safety-net hospitals is lobbying Congress to restore provider cuts built into the new federal health care law in light of the uncertainty over how many states will choose to opt out of the law’s Medicaid expansion provision.

Safety-net and public hospitals, many of which are owned by local governments, could be on the hook for $53.3 billion in uncompensated care costs through 2019 due to a higher number of uninsured patients than originally expected when the law was written, the National Association of Public Hospitals and Health Systems, which has 200 members, said in a report out Friday. The Affordable Care Act relies on deep cuts in Medicaid disproportionate share hospital funding, which is federal payments to cover uninsured patients that mostly go to safety-net hospitals. Cuts in DSH payments start in 2014 and are scheduled to reach $14.1 billion, or nearly 50% of the program, by 2019.

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