United States 119th Congress Status: In Committee 1 R cosponsors

HR 4258 — To amend title XVIII of the Social Security Act to expand the definition of critical access hospital under the Medicare program to include certain hospitals on Indian reservations.

Last action — Referred to the House Committee on Ways and Means.

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill is in committee in the House. Introduced June 30, 2025. It must pass committee before a floor vote.

Next likely step: a committee vote, then a floor vote in the House.

Prognosis

Stalled 16% · moderate confidence

Where this bill stands today.

Odds of enactment

Low

How often bills like it became law.

  • In Committee

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (1 R).

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

In plain language

The bill expands Medicare's critical access hospital definition to include certain Indian reservation hospitals.

This bill allows certain hospitals located on Indian reservations to be designated as critical access hospitals under Medicare. It establishes specific criteria for this designation starting from August 1, 2025.

What this means for you
  • Families: This could improve access to healthcare services for families living on Indian reservations.

Bill Text

Sections of law this bill changes

From the bill's own amending language, matched to the official United States Code (current through Public Law 119-121).

Also cites: 42 U.S.C. § 1395i

How this bill changes current law

4 changes Share ↗

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill expands the definition of critical access hospital under the Medicare program to include certain hospitals on Indian reservations.

  • 42 U.S.C. 1395i-4(c)(2)

    The total → Subject to subparagraph (F), the total

    Modifies the stipulation regarding the total number of critical access hospitals to include a conditional clause for certain reservations.

  • 42 U.S.C. 1395i-4(c)(2)

    "(F) Hospitals on indian reservations.--(i) In general.--Beginning August 1, 2025, a State may designate a facility as a critical access hospital if the facility--(I) is located on a reservation (as defined in section 4 of the Indian Health Care Improvement Act); and (II) is located more than a 35-mile drive (or, in the case of mountainous terrain or in areas with only secondary roads available, a 15-mile drive) from a hospital, or another facility described in this subsection, that--(aa) is located on a reservation (as so defined); or (bb) is operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act)."

    Adds a new provision that allows states to designate certain facilities on Indian reservations as critical access hospitals based on specific geographic criteria.

  • 42 U.S.C. 1395i-4(c)(2)

    "(ii) Psychiatric and rehabilitation distinct part units.--A facility described in clause (i) may establish a distinct part unit under subparagraph (E) without regard to the limitation on number of beds under clause (ii) of such subparagraph."

    Allows facilities on Indian reservations that meet the criteria to establish distinct rehabilitation or psychiatric units without restrictions on bed limitations.

  • 42 U.S.C. 1395i-4(c)(2)

    is located → subject to subparagraph (F), is located

    Adds a conditional clause that refers to the new provision about hospitals on reservations.

Action History

  1. Introduced in House

  2. Introduced in House

  3. Referred to the House Committee on Ways and Means.

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 546 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (546)

546 members have not signed on to this bill.

Show all 546 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

taxation veterans healthcare
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Frequently asked questions

Who sponsors HR 4258?
HR 4258 is sponsored by Newhouse, Dan (Republican).
What is the current status of HR 4258?
This bill is in committee in the House. Introduced June 30, 2025. It must pass committee before a floor vote.
Where can I track HR 4258?
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