Read twice and referred to the Committee on Finance.
The bill (SOLES Act) amends the Social Security Act to require that hospital outpatient prospective payments for sole community hospitals located in Alaska and Hawaii reach at least 94% of those hospitals' reasonable costs for covered outpatient department services. The provision does not change beneficiary copayments, exempts the additional payments from budget-neutrality rules, and requires the Secretary to issue implementing regulations within six months, effective the next January 1.
Disagreement over non-budget-neutral payments and fiscal offsets
Narrow, place‑based spending increase may attract support but faces scrutiny over new Medicare outlays and precedent for carve‑outs.
The bill (SOLES Act) amends the Social Security Act to require that hospital outpatient prospective payments for sole community hospitals located in Alaska and Hawaii reach at least 94% of those hospitals' reasonable costs for covered outpatient department services.
The provision does not change beneficiary copayments, exempts the additional payments from budget-neutrality rules, and requires the Secretary to issue implementing regulations within six months, effective the next January 1.
Relatively narrow, administrable change with clear beneficiaries increases chances, but additional federal spending and precedent for geographic exceptions lower likelihood.
How solid the drafting looks.
Disagreement over non-budget-neutral payments and fiscal offsets
These are examples from the analysis, not a ranked list of the most-affected groups.
Disagreement over non-budget-neutral payments and fiscal offsets
Likely supportive because it protects emergency and outpatient services in remote communities.
Sees it as a targeted federal intervention to prevent closures and preserve access for vulnerable populations.
Generally favorable to targeted support for geographically isolated hospitals, but cautious about fiscal discipline and implementation details.
Would seek cost controls, transparent reporting, and possibly a sunset or review clause.
Skeptical because it creates non-budget-neutral federal spending and expands entitlements without offsets.
Might accept minimal, time-limited help for strategic or frontier hospitals if costs are offset.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Relatively narrow, administrable change with clear beneficiaries increases chances, but additional federal spending and precedent for geographic exceptions lower likelihood.
The bill has not accumulated any surfaced votes yet.
Disagreement over non-budget-neutral payments and fiscal offsets
Relatively narrow, administrable change with clear beneficiaries increases chances, but additional federal spending and precedent for geogr…
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