Sponsors (18)
The bill creates a transparent, stable index and multi‑year designations to target support for hospitals serving low‑income patients, but its reliance on Medicare DSH metrics and index thresholds risks leaving some community hospitals and the patients who depend on them without support while adding administrative burdens.
Hospitals that serve a high share of low‑income or uninsured patients will be identified and tracked annually, enabling targeted Medicaid policies and payments to help preserve local access to care.
State governments and hospitals will receive transparent, comparable index values (CBSA/state/national) and a composite score to guide more objective resource allocation and policymaking.
Designated hospitals gain a five‑year designation with renewal, providing planning stability and potential eligibility for sustained support.
Hospitals and rural or smaller community providers that do not generate high Medicare DSH/DSH uncompensated metrics may be overlooked, leaving some local access needs unaddressed.
If policymakers tie funding strictly to the index thresholds, hospitals just below cutoffs and the low‑income patients they serve could lose or fail to gain support, risking reduced services.
MACPAC and related entities will face new reporting and monitoring duties, increasing administrative workload and potentially diverting attention and resources from other Medicaid priorities if not resourced.
Based on analysis of 2 sections of legislative text.
Establishes a statutory definition of "essential health system," requires MACPAC to publish an annual index and list of designated hospitals, and to review related payment policies.
Creates a legal definition for “essential health system” and requires the Medicaid and CHIP Payment and Access Commission (MACPAC) to publish an annual index and a public list of hospitals that meet that definition. The law sets objective criteria based on Medicare disproportionate share and uncompensated care measures, makes designations last five years, and directs MACPAC to review payment policies that target support to these hospitals to protect access to essential community services.
Introduced January 16, 2026 by Lori Trahan · Last progress January 16, 2026