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Senate GOP leaders make opening offer on hospitals fund

Senate GOP leaders have given their opening offer to their “Medicaid moderates” — a $15 billion stabilization fund for rural hospitals impacted by the pending domestic policy bill.

The details, sent to Senate offices in a memo on Wednesday and confirmed by two people granted anonymity to disclose private negotiations, is unlikely to satisfy a swath of senators concerned that the Senate GOP plan to roll back state provider taxes will negatively impact rural hospitals in their home states. Many states use the taxes to help fund their Medicaid programs.

The offer comes after POLITICO first reported Monday that GOP leaders would include the rural hospital fund in the “big, beautiful bill.” Punchbowl News first reported the initial funding offer Wednesday.

Senators have been clamoring for days to get details of the fund, which GOP leaders privately confirmed in closed-door meetings this week would be included in the megabill . One person who was granted anonymity to describe the talks characterized the $15 billion figure as a “working draft,” predicting that it would change as intense negotiations continue behind the scenes to try to get holdouts on board.

Sens. Josh Hawley (R-Mo.) and Susan Collins (R-Maine) have been some of the most vocal members of the conference raising concerns about the impact on rural hospitals. Both support including a fund while also warning it might not be enough to address their large concerns about the Medicaid changes under consideration; Hawley, for one, has suggested a much higher figure for the fund than what’s now on offer.

Sen. Thom Tillis (R-N.C.) has also privately warned his colleagues about their Medicaid changes, including handing out a fact sheet this week that estimated how much money several states, including his and Hawley’s, would lose under the provider tax proposal. The loss figures Tillis cited are larger than the $15 billion stabilization fund offer.

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