Reading HR 3200 ... Attention CRNAs and Anesthesiologists .... HR 3200 Section 1704 pages 756-761 DSH - The burden of payment of disproportionate share hospital responsibilities is shifted to the states. Currently the government assists those hospital that receive a disproportionate share of indigent or Medicaid patients as compared to other area hospitals in their locality. This will now be shifted to the states. Thousands of CRNAs work in these urban medical centers that treat a disproportionate share of unemployed, uninsured, or indigent individuals. The funding that presently comes to these urban medical centers significantly assists in offsetting operational costs, such as CRNAs salaries. The loss or reduction of this funding could be devastating to these urban, often very large, medical centers.