Rep. Sewell introduces bipartisan “Save Struggling Hospitals Act”

During National Public Health Week, United States Representative Terri Sewell, D-Alabama, and United States Representative David Kustoff, R-Tennessee, introduced the bipartisan Save Struggling Hospitals Act on Wednesday, legislation aimed at fixing Medicare payment formulas that do not account for the cost pressures facing hospitals in rural and lower-wage areas. Senator Mark Warner, D-Virginia, and Senator Marsha Blackburn, R-Tennessee, are leading companion legislation in the Senate.

“Alabama has endured some of the most devastating hospital closures in the nation. Each one leaves families traveling farther for care, mothers delivering babies without nearby maternity units, and seniors losing access to the doctors they’ve trusted for decades,” Sewell said. “The introduction of the Save Struggling Hospitals Act could not come at a more critical moment. By strengthening the financial foundation of vulnerable hospitals, this bill offers a lifeline to communities that have consistently been asked to do more with less. It will help hospitals keep their doors open so that patients get the care they need, regardless of their ZIP code.”

“Access to health care should not depend on a person’s ZIP code,” Kustoff said. “Many rural hospitals are held back by outdated payment policies that fail to account for the challenges they face. I am proud to introduce this legislation to support these hospitals so they can keep their doors open and continue serving patients who depend on them every day.”

Hospitals in Alabama and across the country serve as a critical point of care, but many continue to face challenges due in part to wage index calculations that do not reflect local economic conditions. Recent data show more than 40 percent of rural hospitals are operating at a loss, with more than 400 at risk of closure, underscoring the need for targeted, responsible reforms.

Under current law, Medicare’s payment structure can leave hospitals in certain regions at a disadvantage, undermining its intent to support access to care across all communities. From fiscal year 2020 through fiscal year 2024, Medicare included a policy to help address this imbalance, but officials have since removed it, creating renewed uncertainty for hospitals that rely on it. The Save Struggling Hospitals Act would permanently restore the wage index adjustment and help ensure those hospitals are treated more fairly within the system.