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HR 8109
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Save Struggling Hospitals Act

To amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy.

Introduced Mar 26, 2026

Latest action (Mar 26, 2026) Referred to the House Committee on Ways and Means.

Referred to
Ways and Means Committee
Policy area
Health
Issues
Healthcare

Summary
  • Codifies the Medicare low-wage index hospital policy as a permanent provision of law rather than a time-limited policy.
  • Increases the area wage index for hospitals located in areas with below-median wages by half the difference between their current index and the 25th percentile index.
  • Requires the adjustment to be applied in a budget neutral manner without decreasing wage indices for hospitals below the 75th percentile or reducing any hospital's index below 95 percent of its prior year level.

AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.

Sponsor (1)
5 cosponsors

Money behind the sponsor

Top reported contributors to David Kustoff’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.

  • BLACKSTONE $35,000
  • APOLLO GLOBAL MANAGEMENT $24,400
  • UROLOGY OF INDIANA $14,400
  • TOWER VENTURES $14,200
  • MID-AMERICA APARTMENT COMMUNITIES INC. $13,200

Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for David Kustoff → · Outside spending →

Actions (2)
  1. Mar 26, 2026 Referred to the House Committee on Ways and Means. · house
  2. Mar 26, 2026 Introduced in House

Similar bills (6)

Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.

  • S 4233 — Save Struggling Hospitals Act · Introduced Mar 26, 2026 · Cong. 119 92%
  • S 5085 — A bill to amend the Internal Revenue Code of 1986 to apply inflation adjustments to the additional hospital insurance tax on high income taxpayers. · Introduced Jul 22, 2026 · Cong. 119 72%
  • HR 7520 — Efficiency Adjustment Delay Act · Introduced Feb 12, 2026 · Cong. 119 70%
  • HR 9709 — Medicare Premiums Reduction Act of 2026 · Introduced Jul 15, 2026 · Cong. 119 69%
  • HR 7727 — Sustaining Rural Healthcare Act · Introduced Feb 26, 2026 · Cong. 119 67%
  • S 3688 — RURAL Rate Act · Introduced Jan 15, 2026 · Cong. 119 67%

Text versions (1)
  • Introduced in House · Mar 26, 2026

Only one text version is on file, so there’s no earlier version to compare against yet.

Full text

IN THE HOUSE OF REPRESENTATIVES

March 26, 2026

Mr. Kustoff (for himself and Ms. Sewell) introduced the following bill; which was referred to the Committee on Ways and Means

A BILL

To amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the “Save Struggling Hospitals Act”.

SEC. 2. CODIFICATION OF THE MEDICARE LOW-WAGE INDEX HOSPITAL POLICY.

Section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 1395ww(d)(3)(E)) is amended—

(1) in clause (i), in the first sentence, by striking “or

(iv)” and inserting “, (iv), or (v)”; and

(2) by adding at the end the following new clause:

“(v) Area wage index adjustment for low- wage hospitals.—

“(I) In general.—For discharges occurring on or after October 1, 2019, the area wage index applicable under this subparagraph for a fiscal year to a hospital with an area wage index (determined without regard to this clause) below the 25th percentile area wage index shall be increased by \1/2\ of the difference between the otherwise applicable final area wage index for such fiscal year for such hospital and the 25th percentile area wage index for such fiscal year across all hospitals.

“(II) Budget neutrality.— Pursuant to the fourth sentence of clause (i), this clause shall be applied in a budget neutral manner. Any adjustments made for the purposes of such application of budget neutrality may not— “(aa) decrease the area wage index applicable under this subparagraph to a hospital with an area wage index (determined without regard to this clause) below the 75th percentile area wage index for the fiscal year; or “(bb) result in an area wage index applicable under this subparagraph to a hospital for such fiscal year that is less than 95 percent of the area wage index applicable under this subparagraph to such hospital for the preceding fiscal year.”. <all>

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