Congress guarantees Alaska and Hawaii hospitals 94% cost reimbursement
H.R. 4250 — SOLES Act · Filed by Nicholas Begich (R-AK) · 2 cosponsors · Introduced Jun 30, 2025 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill amends Medicare's hospital outpatient payment rules to guarantee that sole community hospitals in Alaska and Hawaii receive at least 94% of their reasonable costs for outpatient services. If Medicare's standard payment formula would pay them less, the bill requires the Secretary of Health and Human Services to increase the payment to reach that 94% floor. The increase is not subject to budget-neutrality requirements, meaning it adds to overall Medicare spending rather than offsetting costs elsewhere.
Why we flagged it
The bill's operative mechanism is a straightforward payment guarantee for a specific class of hospitals in two states. It is a targeted reimbursement adjustment, not a broader policy reform or deregulation.
What the text implies
- The 94% floor applies only to Alaska and Hawaii, creating a geographic carve-out that may invite similar demands from other rural states or regions with sole community hospitals.
- Exemption from budget-neutrality requirements means this payment increase is not offset by reductions elsewhere in the outpatient payment system, adding to net Medicare expenditure.
The full analysis lists 4 implications of this text.
Who stands to gain
sole community hospitals in Alaska and Hawaii