Sponsors (2)
This bill provides targeted, multi-year federal funding to keep rural emergency departments open and avert closures, at the cost of increased federal spending, eligibility and use restrictions, and additional administrative requirements for small hospitals.
Rural hospitals that operate 24-hour emergency departments will receive steady federal payments (a $1,000,000 year-one base paid quarterly) plus need-based supplements (up to 50% additional annual funding) and short emergency payments (up to $250,000) to help avert ED closures and keep local emergency services open.
The law establishes a dedicated, ongoing Fund with appropriations through 2036, giving multi-year predictable federal support for rural ED operations rather than one-off grants.
Payments from the program are excluded from Medicare cost-settlement calculations, simplifying reimbursement accounting and reducing certain billing/reconciliation headaches for enrolled hospitals.
Federal taxpayers will fund the program through unspecified 'as necessary' appropriations beginning FY2026, increasing federal spending over the next decade without a fixed dollar cap.
Funds are restricted to emergency department operations and cannot be used for other investments or transferred to other facilities, limiting flexibility for integrated rural health system planning or broader capital needs.
Entities acquired by private equity or venture capital are barred from participating, which could disqualify some community hospitals, complicate planned sales or recapitalizations, and affect local ownership decisions.
Based on analysis of 2 sections of legislative text.
Creates a Treasury fund and directs HHS/HRSA to run a 10‑year program making base, discretionary, and emergency payments to eligible rural hospital emergency departments.
Official title: Establish a guaranteed funding stream to keep existing emergency rooms at America's rural hospitals open, and for other purposes.
Introduced June 24, 2026 by Joshua David Hawley · Last progress June 24, 2026
Creates a permanent Treasury fund administered by HHS to make multi-year and emergency payments to eligible rural hospital emergency departments to help prevent ED closures and support operations. The statute requires HHS/HRSA to establish a 10-year grant/payment program within 90 days that provides a $1,000,000 base payment in year one per eligible entity (quarterly), indexes later years to the medical CPI, allows up to a 50% discretionary add‑on per year based on need and payor mix, and permits a one‑time emergency payment up to $250,000 if an ED faces imminent closure.