The healthcare sector is weighing in as lawmakers negotiate with the White House to avoid the so-called fiscal cliff, a combination of tax increases and spending cuts set to take effect Jan. 1.
Long-term deficit reduction will almost certainly involve overhauling entitlements.
While Medicare has received more attention in the debate so far, advocates for Medicaid are concerned that the program may be seen as an easy target.
"[Deficit-reduction] proposals vary, but all would strip away billions of dollars from a program that already faces severe funding shortfalls," the NAPH said in a memo to the press.
The group added that safety-net hospitals were left the in lurch by the Supreme Court decision on healthcare reform, which made the law's Medicaid expansion optional.
"In expectation of a full national expansion of Medicaid, the Affordable Care Act dramatically reduced federal payments to hospitals that serve a disproportionate share of uninsured," the memo stated.
"But the Supreme Court upset that balance by making expansion voluntary for states, many of which have since balked at expanding coverage."
Medicaid also received attention at the White House Tuesday, as governors visited President Obama to discuss the fiscal cliff.
According to reporters, governors expressed concerns that a deficit-reduction deal could force states to shoulder more costs for the health law's Medicaid expansion.
"We did talk briefly about the potential unintended consequences [of the cliff] as it relates to Medicaid," Gov. Jack Markell (D-Del.) told the press Tuesday.
"Some of us have made the decision to expand Medicaid," he said.
"In our case we made that decision because of the underlying economics... the fact that there's a higher federal reimbursement for the population we're already serving. If that were changed we would have to revisit that decision."