Sponsor
Joshua David Hawley
Senator · R-MO
The bill provides substantial targeted funding to transform rural health care and preserve existing Medicaid provider tax rules, improving access in many rural areas but increasing federal spending and creating risks of uneven aid distribution and legal/administrative disruption.
Rural communities, hospitals, and state health programs: receive $10 billion per year (FY2031–2035) — $50 billion total — to fund rural health transformation (expanded clinics, telehealth, workforce incentives), improving access to care and supporting local health-sector jobs.
Hospitals, Medicaid providers, Medicaid beneficiaries, and state governments: reversion to pre-Section 71115 provider tax rules avoids new provider tax restrictions or payment reductions, preserving current state Medicaid financing arrangements and reducing risk of sudden service disruptions.
Local rural economies and health workforces: the federal investment is likely to support job retention and creation in the rural health sector, benefiting local economic activity.
Taxpayers and federal budgets: creates $50 billion in new mandatory appropriations over five years, increasing federal spending and potentially adding to deficits or requiring offsets.
Programs, contractors, and agencies: rescinding previously appropriated funds removes expected resources, delaying or terminating planned activities and creating administrative burdens and potential legal disputes for recipients and agencies.
Taxpayers and state Medicaid programs: repealing Section 71115 could permit some states to continue or resume taxing or financing practices the amendment sought to limit, shifting Medicaid costs and increasing burdens on taxpayers or beneficiaries.
Based on analysis of 4 sections of legislative text.
Restores prior Medicaid provider tax law by repealing two sections of a prior Act, rescinds certain appropriations, and adds $10B per year for FY2031–FY2035 for rural health transformation.
Official title: Repeal the changes to Medicaid State provider tax authority and State directed payments made by the One Big Beautiful Bill Act and provide increased funding for the rural health transformation program.
Introduced July 15, 2025 by Joshua David Hawley · Last progress July 15, 2025
Senator · R-MO
Repeals two provisions of Public Law 119–21 that changed state Medicaid provider tax authority and cancels previously appropriated amounts tied to one of those provisions, effectively restoring prior law for Medicaid provider taxes. It also adds five new annual $10 billion appropriations (FY2031–FY2035) to boost funding for the Rural Health Transformation Program, increasing authorized allotments for rural health transformation over those years.