Sponsors (26)
The bill creates a transparent, five‑year designation system to target and stabilize support for safety‑net hospitals and preserve local access to care, but it may exclude some community hospitals that don’t fit Medicare‑based metrics and adds administrative burdens that could leave vulnerable patients worse off.
Low-income patients and community hospitals: the bill identifies and annually tracks hospitals that meet safety‑net criteria so Medicaid policies and payments can be targeted to help preserve local access to care.
Designated hospitals: a five‑year designation with renewal gives hospitals predictable status for planning and potential eligibility for sustained support.
State governments and hospitals: creates transparent, comparable index values (CBSA/state/national) and a composite score to help policymakers allocate resources based on objective metrics.
Rural and community hospitals: by basing designations largely on Medicare DSH and uncompensated care metrics, the bill may miss other local access needs and leave some community hospitals without support.
Low-income patients and vulnerable populations: if policymakers tie funding to the index, hospitals just below thresholds could lose or fail to gain support, risking reduced services for vulnerable patients.
State governments and MACPAC: new reporting and monitoring duties create administrative workload that could divert attention and resources from other Medicaid priorities if not adequately resourced.
Based on analysis of 2 sections of legislative text.
Establishes a statutory definition of “essential health system” and requires MACPAC to publish an annual index and list of designated hospitals.
Official title: To amend title XIX of the Social Security Act to establish a definition of essential health system in statute and for other related purposes.
Introduced January 16, 2026 by Lori Trahan · Last progress January 16, 2026
Creates a statutory definition of “essential health system” for certain subsection (d) hospitals and requires MACPAC to publish an annual index and list of designated essential health systems. The designation is based on high shares of Medicare disproportionate patient percentage or uncompensated care (or a state‑adjusted top‑16th percentile) over recent years and lasts five years, with renewal allowed. Directs MACPAC to submit the first list to Congress within six months of enactment and then annually by August 1, publish index values at local, state, and national levels, and review payment policies that target support to these hospitals to ensure continued access to essential community services.