Save Struggling Hospitals Act
- Bill Number
- S. 4233
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-03-26: Read twice and referred to the Committee on Finance.
- Last Updated
- 2026-05-12T11:03:32Z
AI-Generated Summary
Purpose
The Save Struggling Hospitals Act (S. 4233) aims to make permanent (codify into law) a Medicare policy that provides extra payment adjustments to hospitals in areas with low labor costs. This helps these hospitals receive fairer Medicare reimbursements for inpatient services by adjusting the area wage index—a measure Medicare uses to account for differences in local wages when paying hospitals.
Key Provisions
- Eligibility: Applies to hospitals whose area wage index (before adjustment) ranks below the 25th percentile (the level below which 25% of all hospitals fall).
- Adjustment: Increases the hospital's wage index by half the difference between its unadjusted index and the 25th percentile index for that fiscal year.
- Effective Date: Covers hospital discharges (patient releases) on or after October 1, 2019.
- Budget Neutrality: The policy must not increase total Medicare spending. Adjustments to achieve this:
- Cannot lower the wage index for hospitals below the 75th percentile.
- Cannot result in any hospital's wage index dropping below 95% of its index from the previous fiscal year.
Significant Changes to Existing Law
- Amends Section 1886(d)(3)(E) of the Social Security Act, which governs Medicare's inpatient hospital payment adjustments.
- Adds a new clause (v) detailing the low-wage hospital adjustment.
- Updates existing clause (i) to include this new provision in budget-neutrality calculations.
- Converts what was likely a temporary regulatory policy into permanent statutory law.
Potential Impacts
- Hospitals: Boosts Medicare payments to low-wage hospitals (often rural or in economically challenged areas), potentially improving their financial stability and ability to provide care.
- Medicare Program: Maintains overall spending levels through redistribution—no net increase in costs to the program.
- Citizens/Patients: May enhance healthcare access in underserved areas by supporting struggling hospitals, without raising Medicare costs.
- No direct impacts on international relations or non-health government agencies.
Main Stakeholders Affected
- Low-wage hospitals (primary beneficiaries, especially rural and small facilities).
- Medicare beneficiaries in low-wage areas (better hospital sustainability).
- Centers for Medicare & Medicaid Services (CMS) (implements adjustments).
- Taxpayers (protected by budget neutrality).
Notable Legal, Constitutional, or Political Implications
- Legal: Locks in the policy as federal law, reducing reliance on annual rulemaking and providing hospitals with payment certainty.
- Constitutional: No apparent issues; fits within Congress's authority over federal spending programs like Medicare.
- Political: Bipartisan sponsorship (Sens. Warner, Blackburn, Hyde-Smith, Tuberville) signals broad support for aiding vulnerable hospitals; could influence future Medicare payment debates by prioritizing equity in wage adjustments.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (5)
Sen. Blackburn, Marsha [R-TN], Sen. Hyde-Smith, Cindy [R-MS], Sen. Tuberville, Tommy [R-AL], Sen. Hagerty, Bill [R-TN], Sen. Boozman, John [R-AR]
Recent Actions
- 2026-03-26: Read twice and referred to the Committee on Finance.
- 2026-03-26: Introduced in Senate
Bill Versions
- Save Struggling Hospitals Act — issued 2026-03-26 — PDF (3 pages)