WASHINGTON––U.S. Senators John Boozman (R-AR), Chuck Grassley (R-IA) and Peter Welch (D-VT) introduced the Rural Hospital Support Act to prevent rural hospital closures by extending and modernizing critical Medicare programs. 

“Hospitals are one of the last community pillars still standing in rural America. They not only offer accessible, vital health care but also provide key economic benefits that cannot be replicated. As these institutions continue to face headwinds threatening their viability, we can help sustain them by supporting fair and adequate reimbursement for their services,” Boozman said. 

“As a lifelong resident of rural Iowa, I know the importance of having access to health care services close to home. In addition to providing life-saving care, rural hospitals are a source of economic security for many rural communities,” Grassley said. “Our bipartisan bill will ensure the continuity of these vital programs and help keep rural hospitals’ doors open.”

“Rural hospitals provide essential care to patients in rural communities, including to folks who rely on Medicare and Medicaid. In Vermont, rural hospitals are also job creators and economic drivers. But across the country, rural hospitals are struggling to stay open, and they need a lifeline,” Welch said. “Our bipartisan legislation will help ensure rural hospitals are reimbursed for resources they need to continue delivering vital care in our rural communities.”

Specifically, the Rural Hospital Support Act would:

• Permanently extend the Medicare-Dependent Hospital (MDH) program to ensure eligible rural hospitals are reimbursed for their costs;
• Permanently extend the Low-Volume Hospital (LVH) program to level the playing field for rural hospitals whose operating costs often outpace their revenue; and
• Update the rebasing year for Sole Community Hospitals (SCH) and MDHs to allow hospitals to tie reimbursement estimates to more recent trends in costs.

The bipartisan legislation is also cosponsored by Senators Shelley Moore Capito (R-WV), Tim Kaine (D-VA), Roger Wicker (R-MS), Jeanne Shaheen (D-NH), Jerry Moran (R-KS), Tina Smith (D-MN), Cindy Hyde-Smith (R-MS), John Fetterman (D-PA), Mark Kelly (D-AZ), Roger Marshall, M.D. (R-KS) and Gary Peters (D-MI). 

The Rural Hospital Support Act has garnered support from stakeholders including the Alliance for Rural Hospital Access, the American Hospital Association and the National Rural Health Association.

Background

Rural hospitals provide critical care for patients, many of whom rely on Medicare and Medicaid. These hospitals also serve as economic anchors – accounting for around 14 percent of total employment in rural areas.

The MDH and LVH programs have supported rural communities for decades. The programs were last extended as part of the Continuing Resolution on December 20, 2024, and would expire on March 31, 2025, without congressional action. The Rural Hospital Support Act does not change other rural hospital Medicare programs including critical access hospitals (CAH), rural referral centers (RRC), Rural Community Hospital Demonstration or the new voluntary rural emergency hospitals (REH). Each of these rural programs offer unique flexibilities to ensure health care services are accessible in rural America.

Find bill text here.