Congress extends rural clinic program five more years.
S. 4460 — Rural Community Hospital Demonstration Program Reauthorization · Filed by Chuck Grassley (R-IA) · 16 cosponsors · Introduced Apr 30, 2026 · Passed chamber
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 extends the Rural Community Hospital Demonstration Program. It goes from 15 years to 20 years. Small rural clinics in the program keep special Medicare payments. They get five more years of this help. Clinics joining between late 2024 and early 2027 can also use the program. They get access during the fourth five-year period.
Who it affects
Rural clinics and their patients are affected. Rural areas that depend on small clinics are affected.
One thing to notice
The bill gives rural clinics more time to plan and invest. Congress must vote each year to pay for it. The extension is permission, not a promise of money.
From the analysis of the bill text, linked under Primary records below.
Where it stands
16 cosponsors: 8 Republicans, 7 Democrats, 1 Independents.
- Apr 30, 2026 — Introduced · Congress.gov: “Introduced in Senate”
- Apr 30, 2026 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance”
- May 20, 2026 — Reported out of committee · Congress.gov: “Senate Committee on Finance discharged by Unanimous Consent”
- May 20, 2026 — Passed the Senate · Congress.gov: “Passed Senate without amendment by Unanimous Consent. (consideration: CR S2428; text: CR S2428)”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
1 groups reported lobbying about this bill. They filed 1 reports from Jun 2026 to Jun 2026.
Those reports show $4,470,000 in lobbying spending. Each report lists about 53 bills. So that money was not all for this bill.
More groups named this bill than 0% of bills with any report.
Chuck Grassley, who sponsored the bill, received $49,167 from PACs for the 2026 election.
- American Hospital Association — $4,470,000 in 1 report
Lobbying is legal. These reports show who lobbied about this bill, not what changed.
Words to know
- Rural Community Hospital Demonstration Program — A Medicare program that gives small rural clinics special payment rules and options.
- Medicare — The federal health insurance program for people age 65 and older and some younger people with disabilities.
- demonstration program — A test program that tries out new ways to pay for or run healthcare services.
- lobbying — Trying to influence lawmakers about a bill. Companies and groups pay people to do this.
- PACs — Groups that collect money and give it to candidates for office.
- sponsored — To sponsor a bill is to introduce it in Congress and put your name on it.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (2,221 characters) on Jul 5, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 14,522 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Jun 2026 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 20, 2026 · page rendered 2026-09-22.
“Congress extends rural clinic program five more years.” QuorumCivic. https://share.quorumcivic.app/bill/119/s4460/simple Report an error