Congress·In Committee·H.R. 1805

Congress moves to extend Medicare rural hospital payment boosts through 2031, orders report on rural categories

ARCH Act

about 1 year ago·View on Congress.gov

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Stalled

No legislative action in over 90 days.

Legislative Progress

House

Senate

President

Law

Key Points

Extends Medicare’s special extra payments for certain small rural hospitals and low-volume hospitals from early 2025 out to 2031.
This is meant to help rural hospitals keep their doors open by giving them steadier Medicare funding when they serve fewer patients.
It also tells the Government Accountability Office to report to Congress within 180 days on how Medicare labels different kinds of rural hospitals and where those labels overlap.
The report must suggest ways to simplify the rural hospital categories and propose changes that could improve rural hospitals’ finances and patients’ access to care.
If you live in a rural area, this could reduce the risk of losing local hospital services, like emergency care or inpatient beds, due to financial strain.

HealthcareMedicare Medicaid

Impact Analysis

Personal Impact

How this policy affects specific groups of people

Positive Impacts(3)

Medicare

Helps

Chronic Illness

Helps

Disability Benefits

Helps

Milestones

2 milestones2 actions

Mar 3, 2025House

Referred to the House Committee on Ways and Means.

Mar 3, 2025

Introduced in House

What Happens Next

Projected impacts based on AI analysis

As soon as the law is enacted

If enacted before the current expiration dates, the special Medicare payment rules for Medicare-dependent hospitals continue instead of ending.

Small rural hospitals that qualify could avoid a sudden drop in Medicare revenue, making closures or service cutbacks less likely.

2031-10-01

Medicare-dependent hospital (MDH) payment extension runs through October 1, 2031.

Qualifying rural hospitals can plan budgets and staffing with more certainty for multiple years.

Through calendar year 2031 and into federal fiscal year 2032

Low-volume hospital (LVH) payment extension runs through 2031, with continued payment schedule into fiscal year 2032.

Hospitals with very low Medicare inpatient volume keep getting extra support longer, which may help keep inpatient and emergency services available locally.

Within 6 months after the law is enacted

GAO submits a report to Congress on rural hospital classifications within 180 days after enactment.

Could set up later changes that simplify rural hospital labels and better target financial help, but nothing changes for patients until Congress or Medicare acts on the findings.