H.R. 10086House118th Congress (2023-2025)In Committee

Save Struggling Hospitals Act

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Updated January 20, 2026 at 7:50 PM UTC

The Save Struggling Hospitals Act amends Title XVIII of the Social Security Act to formally codify a Medicare “low‑wage index hospital” policy. It raises the Medicare area wage index for hospitals whose index falls below the 25th percentile, increasing it by half the difference between their actual index and the 25th‑percentile level, applied in a budget‑neutral way. The change applies to discharges on or after October 1, 2019 and is intended to provide additional payment support to financially vulnerable hospitals.

Key Provisions

Adds a new clause (v) that defines “low‑wage hospitals” and specifies an adjustment to their Medicare area wage index.
The adjustment increases the index by ½ of the gap between the hospital’s current index and the 25th‑percentile index for that fiscal year.
The provision applies to discharges occurring on or after October 1, 2019 and must be budget neutral.
Amends existing clause (i) to include the new (v) option in the list of applicable categories.

Legislative Activity

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2 earlier actions

HouseCommittee Latest Action

Referred to the Subcommittee on Health.

Health Subcommittee

December 17, 2024

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HouseIntro Referral

Introduced in House

November 1, 2024

HouseIntro Referral

Referred to the House Committee on Ways and Means.

Ways and Means Committee

November 1, 2024

HouseCommittee

Referred to the Subcommittee on Health.

Health Subcommittee

December 17, 2024

Bill Text

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Introduced in HouseIssued November 1, 2024

118th CONGRESS

2d Session

H. R. 10086

IN THE HOUSE OF REPRESENTATIVES

November 1, 2024

Mr. Ferguson (for himself and Mr. Griffith) introduced the following bill; which was referred to the Committee on Ways and Means

A BILL

To amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy.

Short title

This Act may be cited as the Save Struggling Hospitals Act.

Codification of the Medicare low-wage index hospital policy

Section 1886(d)(3)(E) of the Social Security Act (42 U.S.C. 1395ww(d)(3)(E)) is amended—

(1)

in clause (i), in the first sentence, by striking or (iv) and inserting , (iv), or (v); and

(2)

by adding at the end the following new clause:

(v)

Low-wage hospitals

For discharges occurring on or after October 1, 2019, the area wage index applicable under this subparagraph for a fiscal year to a hospital with an area wage index below the 25th percentile area wage index shall be increased by ½ of the difference between the otherwise applicable final area wage index for such fiscal year for such hospital and the 25th percentile area wage index for such fiscal year across all hospitals. Pursuant to the fourth sentence of clause (i), the preceding sentence shall be applied in a budget neutral manner.