Save Struggling Hospitals Act
- Bill Number
- H.R. 8109
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-03-26: Referred to the House Committee on Ways and Means.
- Last Updated
- 2026-04-29T08:06:58Z
AI-Generated Summary
Purpose
The Save Struggling Hospitals Act (H.R. 8109) aims to make permanent (codify into law) a Medicare policy that provides wage index adjustments to hospitals in low-wage areas. Wage index is a factor used to adjust Medicare payments to hospitals based on local labor costs, helping ensure fair compensation in areas where wages are lower.
Key Provisions
- Adjustment for Low-Wage Hospitals: Starting for patient discharges on or after October 1, 2019, hospitals with a wage index below the 25th percentile (the lowest 25% of all hospitals) receive an increase equal to half the difference between their wage index and the 25th percentile wage index for that fiscal year.
- Budget Neutrality: The adjustment must be applied without increasing overall Medicare spending (budget neutral). To achieve this:
- No hospital with a wage index below the 75th percentile (the lowest 75% of all hospitals) can have its wage index decreased.
- No hospital's wage index can drop below 95% of its previous year's wage index.
Significant Changes to Existing Law
- Amends Section 1886(d)(3)(E) of the Social Security Act, which governs Medicare's hospital payment adjustments.
- Adds a new clause (v) to explicitly include this low-wage hospital policy alongside existing adjustments (clauses i and iv).
- Converts what was likely a temporary or regulatory policy into permanent statutory law, applied retroactively from fiscal year 2020 onward.
Potential Impacts
- Hospitals: Boosts Medicare payments to low-wage hospitals (often rural or struggling), potentially improving their financial stability and ability to provide care.
- Medicare Program: Maintains overall spending levels through budget neutrality, shifting funds from higher-wage hospitals (with protections) to low-wage ones.
- Citizens: Could enhance access to hospital care in underserved, low-wage areas without raising Medicare costs for beneficiaries or taxpayers.
- No direct impact on international relations or non-health government agencies.
Main Stakeholders Affected
- Low-wage hospitals (primary beneficiaries, e.g., rural or economically disadvantaged facilities).
- Higher-wage hospitals (may see minor payment adjustments but protected from deep cuts).
- Centers for Medicare & Medicaid Services (CMS): Must implement and administer the codified policy.
- Medicare patients and providers in affected areas.
- Taxpayers/federal budget: Neutral impact due to budget rules.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens the policy by embedding it in statute, reducing reliance on annual rulemaking and making it harder to reverse administratively.
- Constitutional: No apparent issues; aligns with Congress's authority over federal spending programs like Medicare.
- Political: Bipartisan sponsorship (Reps. Kustoff and Sewell); targets "struggling hospitals," potentially appealing to rural and urban districts alike, but could spark debate over payment redistribution. Referred to House Ways and Means Committee for review.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (5)
Rep. Sewell, Terri A. [D-AL-7], Rep. Harshbarger, Diana [R-TN-1], Rep. Fleischmann, Charles J. "Chuck" [R-TN-3], Rep. Figures, Shomari [D-AL-2], Rep. DesJarlais, Scott [R-TN-4]
Recent Actions
- 2026-03-26: Referred to the House Committee on Ways and Means.
- 2026-03-26: Introduced in House
- 2026-03-26: Introduced in House
Bill Versions
- Save Struggling Hospitals Act — issued 2026-03-26 — PDF (3 pages)