New bills would boost Medicare payments for Hawaiʻi and Alaska hospitals

US Reps. Jill Tokuda of Hawaiʻi and Nick Begich of Alaska recently introduced two bills to help with Medicare underpayments to rural hospitals in Hawaiʻi and Alaska.

Named the Save our Lone Emergency Services Act and the Ensuring Outpatient Quality for Rural States Act, these measures would ensure that Medicare payments better reflect the significantly higher costs of delivering healthcare in noncontiguous states.

Hawaiʻi and Alaska face unique challenges that drive up healthcare costs. These include their isolated geography, limited infrastructure, difficulties in recruiting and keeping healthcare professionals, and the exceptionally high costs of living. Now, Medicare often reimburses rural hospitals in these states at the same rates as those in the continental US, making it especially tough for them to provide care to remote communities.

A breakdown of the bills:

• SOLES Act: This bill would create a minimum payment level for Medicare to isolated community hospitals in Hawaiʻi and Alaska. This aims to give these facilities the financial stability they need to continue offering essential health services.
• Ensuring Outpatient Quality for Rural States Act: This bill would authorize a cost-of-living adjustment for Medicare-covered hospital outpatient services in Hawaiʻi and Alaska.

Together, these measures would ensure that the Centers for Medicare and Medicaid Services consider the higher regional costs faced by remote healthcare facilities when determining how much to reimburse them.

“Providing quality healthcare in Hawaiʻi and Alaska costs more, whether it’s due to the geographic isolation, limited infrastructure, difficulty recruiting and retaining healthcare professionals, or the exceptionally high cost of living. Yet, Medicare continues to reimburse rural hospitals in the noncontiguous states at the same rate as those in the US mainland, making it especially difficult to deliver care to our remote communities,” said Tokuda, co-chair of the Bipartisan Rural Health Caucus.

Begich, a Republican, echoed these concerns. He said Medicare reimbursement formulas have long failed to reflect the true cost of care in rural and remote areas like Alaska and Hawaiʻi. He stressed that these bipartisan bills are essential to protecting access to critical inpatient and outpatient services for rural communities.