Established in 1981, the Medicaid disproportionate share hospital payment program provides funding to hospitals that provide a disproportionate share of a state’s care for those who are uninsured and those with Medicaid. In Texas, the Medicaid DSH program is one of only two Medicaid supplemental payment programs that help support hospitals’ costs of providing uninsured care, making it critical in a state with an uninsured rate of more than 18 percent.