Read twice and referred to the Committee on Finance.
The bill amends the Medicare physician fee schedule (Social Security Act §1848(e)) to set a minimum work geographic index of 1.5 for physician services furnished in Hawaii, effective January 1, 2026. If the calculated index would be below 1.5, the Secretary must increase it to 1.5.
Liberals focus on access and equity gains for Hawaii beneficiaries
Relative to its intended legislative type, this bill is a narrowly focused substantive modification to Medicare payment law that is clearly drafted to produce a specific change to the physician work geographic index for services in Hawaii.
The bill amends the Medicare physician fee schedule (Social Security Act §1848(e)) to set a minimum work geographic index of 1.5 for physician services furnished in Hawaii, effective January 1, 2026.
If the calculated index would be below 1.5, the Secretary must increase it to 1.5.
The increase is explicitly not required to be budget neutral, so it raises Medicare payments for Hawaii physicians without offsetting reductions elsewhere.
Simple and sympathetic to local providers but increases federal spending and sets precedent; more likely as part of a broader package than standalone.
Relative to its intended legislative type, this bill is a narrowly focused substantive modification to Medicare payment law that is clearly drafted to produce a specific change to the physician work geographic index for services in Hawaii.
Liberals focus on access and equity gains for Hawaii beneficiaries
These are examples from the analysis, not a ranked list of the most-affected groups.
Liberals focus on access and equity gains for Hawaii beneficiaries
Likely broadly supportive: views the change as a targeted step to improve access and equity for Hawaii residents and rural/island providers.
Sees non-budget-neutral language favorably because it avoids shifting cuts to other providers or beneficiaries.
Cautiously favorable but pragmatic: appreciates addressing access problems in Hawaii while worrying about cost and precedent.
Would prefer evidence, time-limits, or periodic review to ensure effectiveness.
Likely opposed: views the bill as an untargeted, non-budget-neutral spending increase and a precedent for state-specific Medicare carve-outs.
Concerns include federal overreach and long-term cost.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Simple and sympathetic to local providers but increases federal spending and sets precedent; more likely as part of a broader package than standalone.
The bill has not accumulated any surfaced votes yet.
Liberals focus on access and equity gains for Hawaii beneficiaries
Simple and sympathetic to local providers but increases federal spending and sets precedent; more likely as part of a broader package than…
Relative to its intended legislative type, this bill is a narrowly focused substantive modification to Medicare payment law that is clearly drafted to produce a specific change to the physician work geographic index for…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.