Long-Term Rural Health Investment Act of 2026
Revises Medicaid state-directed payment limits and reporting rules, and repeals specified provisions related to provider taxes.
In the House Energy and Commerce Committee since Oct. 5, 2026, 3 days after it was introduced. Most bills never leave committee.
- INTRODUCEDINTROOCT 5, 2026
- COMMITTEECOMM.IN COMMITTEE
- HOUSEHOUSE—
- SENATESENATE—
- LAWLAW—
What the bill would do, and why it matters
States can direct Medicaid managed-care plans to make specified payments to health care providers. The bill would change the limits on those payments, allow states new ways to tie and distribute them, and require detailed reporting. It would also repeal specified Medicaid provider-tax provisions and rescind related appropriated amounts.
- INTRODUCED ONLY This bill has been introduced and possibly referred to a committee, but it has not passed any vote. Most introduced bills never become law — they die in committee without a hearing.
- DATA NOTE No Congressional Research Service summary was available.
- Caps state-directed payments at 200% of Medicare rates
For services in rating periods beginning on or after Jan. 1, 2030, the total payment rate would be capped at 200% of the specified published Medicare rate, or the state average commercial rate if no specified Medicare rate exists. Certain previously approved or submitted payments would be reduced by 10% of the prior rating period’s payment each year until they reach the cap.
- Repeals provider-tax provisions
The bill would repeal sections of Public Law 119-21 related to provider taxes and apply the Medicaid law as if those sections had not been enacted. It would also rescind amounts appropriated under one of those sections.
- Requires detailed state payment reporting
Beginning Jan. 1, 2027, states would report detailed data on state-directed payments, including amounts paid to providers, the sources of states’ non-federal share, and service and payment information. States would submit the data through T-MSIS or a successor system within one year after each rating period ends.
- Allows utilization-based payments and separate disbursements
For services in rating periods beginning on or after Jan. 1, 2028, states could condition certain payments on services delivered outside the rating period and reconcile them to utilization during that period. States could also withhold part of a plan’s final capitation rate to pay separately for these payments, or require plans to retain part of that rate for them.
The bill changes the federal rules that shape how states direct Medicaid payments to providers through managed-care arrangements and how those payments are tracked. It also reverses specified provider-tax provisions and rescinds related appropriated amounts, changing parts of the Medicaid financing framework without establishing a separate rural-health funding program in the text.
Written from the bill text.
The path it took, step by step
- IntroducedOCT 5, 2026HOUSEOCT 5, 2026By Rep. DavidsReferred to Energy and Commerce
- SAME DAYNOWHouse committeeOCT 5, 2026ENERGY & COMMERCE NOWOCT 5, 2026In committee for 3 daysNo hearing yet
- 3 DAYS SO FARPassed the House—HOUSE FLOOR—Not scheduled
- Senate committee—SENATE—
- Passed the Senate—SENATE FLOOR—Not scheduled
- Resolve differencesONLY IF NEEDEDBOTH CHAMBERSONLY IF NEEDEDSkipped if the other chamber passes the same text
- Signed into law—PRESIDENT—10 days to sign or veto
- OCT 52026OCT 5, 2026REFERREDHOUSEReferred to the House Committee on Energy and Commerce.
- OCT 52026OCT 5, 2026INTRODUCEDHOUSEIntroduced in House
At day 3, this bill is already older than 3% of the laws passed this Congress were when they were signed.
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