State No New or Increased Provider Taxes Expected Future Reduction in Hospital, MCO, or Ambulance Taxes Estimated Annual Federal Spending on State Directed Payments (SDPs) Estimated Annual Federal Spending on SDPs, Hospital Services Estimated Federal Spending on Hospital Services Above New Limits First Year Rural Health Fund Award (Million $s) First Year Rural Health Fund Award Per Rural Resident United States 51 31 93135925590 77871811957 60096332117 10,000 $391 Alabama Yes Not an expansion state 0 0 0 203 $126 Alaska Yes No affected taxes 0 0 0 272 $990 Arizona Yes Affected tax(es): hospital 4295550000 3674122000 2954716699 167 $216 Arkansas Yes Affected tax(es): ambulance 0 0 0 209 $159 California Yes Affected tax(es): hospital, MCO, ambulance 10553669609 9258815373 7445908546 234 $85 Colorado Yes Affected tax(es): hospital 347765713 0 0 200 $205 Connecticut Yes Affected tax(es): hospital 0 0 0 154 $478 Delaware Yes No affected taxes 352568078 181962020.7 175574794.4 157 $646 District of Columbia Yes No affected taxes 376029678 376029678 376029678 - $0 Florida Yes Not an expansion state 889405766.5 420618733.5 394258287.2 210 $199 Georgia Yes Not an expansion state 3013567747 2854638468 2171866925 219 $89 Hawaii Yes No affected taxes 320640000 308310000 247941877.1 189 $528 Idaho Yes No affected taxes 0 0 0 186 $284 Illinois Yes Affected tax(es): hospital, MCO 5081466000 4922100000 3957499232 193 $101 Indiana Yes Affected tax(es): hospital 2040600000 0 0 207 $106 Iowa Yes Affected tax(es): hospital 1631935671 1506188637 912669087.9 209 $139 Kansas Yes Not an expansion state 633086200 623187000 256752105.2 222 $191 Kentucky Yes Affected tax(es): hospital, ambulance, other 4344954725 4067793787 3894018212 213 $95 Louisiana Yes Affected tax(es): hospital, MCO, ambulance 4285293186 3287087046 3285446255 208 $188 Maine Yes No affected taxes 0 0 0 190 $274 Maryland Yes No affected taxes 52600000 0 0 168 $348 Massachusetts Yes Affected tax(es): hospital, ambulance 527185626.3 476320000 456539882.5 162 $666 Michigan Yes Affected tax(es): hospital 4583445700 3592409474 2618977936 173 $83 Minnesota* Yes Affected tax(es): hospital 161495701 0 * 193 $114 Mississippi Yes Not an expansion state 2394697246 2351988207 1040555432 206 $118 Missouri* Yes Affected tax(es): hospital 144588402 0 * 216 $104 Montana Yes No affected taxes 0 0 0 234 $394 Nebraska Yes Affected tax(es): hospital 985582394.9 968875884 951287777.9 219 $280 Nevada Yes Affected tax(es): hospital 1147632022 1124037531 899511550.2 180 $596 New Hampshire Yes Affected tax(es): hospital 215770456 200214540.7 18222215.01 204 $326 New Jersey Yes Affected tax(es): hospital, MCO 3336520595 2908773554 2233275948 147 $1,069 New Mexico Yes Affected tax(es): hospital 1779532000 1578792000 1468888501 211 $268 New York Yes Affected tax(es): hospital 2983258790 2664280454 2425381306 212 $101 North Carolina Yes Affected tax(es): hospital 5202893340 4741303439 3443922723 213 $72 North Dakota Yes No affected taxes 0 0 0 199 $561 Ohio Yes Affected tax(es): hospital 3868345318 3279057376 2164799542 202 $69 Oklahoma Yes Affected tax(es): hospital, ambulance 1281796449 1094215692 597462886.8 223 $142 Oregon Yes Affected tax(es): hospital, ambulance 2178138051 2068417497 1191312141 197 $172 Pennsylvania Yes Affected tax(es): hospital, MCO 3618282615 1940056658 1561403280 193 $78 Rhode Island Yes Affected tax(es): hospital, MCO 351587834.3 241571446.3 203498029.6 156 $6,305 South Carolina Yes Not an expansion state 1930114749 1791807606 1647492048 200 $183 South Dakota Yes No affected taxes 0 0 0 189 $379 Tennessee Yes Not an expansion state 2896516169 2571711133 1949584069 207 $94 Texas Yes Not an expansion state 6308311079 4927157878 3477419303 281 $66 Utah Yes Affected tax(es): hospital, ambulance 496270996 438630058 391019866.3 196 $391 Vermont Yes Affected tax(es): hospital 12376153.43 0 0 195 $411 Virginia Yes Affected tax(es): hospital 3457303879 3150296849 2355372812 190 $118 Washington Yes Affected tax(es): ambulance 2173914405 1930700000 1391768801 181 $162 West Virginia Yes Affected tax(es): ambulance, other 1086289464 977660517.6 567162829.2 199 $223 Wisconsin Yes Not an expansion state 1794943782 1372681419 968791539.1 204 $95 Wyoming Yes Not an expansion state 0 0 0 205 $484