United States 119th Congress Status: Passed Senate Bipartisan · 9 R · 7 D · 1 I cosponsors

S 4460 — Rural Community Hospital Demonstration Program Reauthorization

Last action — Held at the desk.

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

This bill has passed the Senate. Introduced April 30, 2026. It now moves to the second chamber.

Next likely step: consideration and a floor vote in the House.

Odds of enactment

Moderate chance

Based on the sponsor, cosponsors, and committee posture, this bill has a moderate chance of becoming law.

Upgrade to see the exact probability and what's driving it.

A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.

Prognosis

Advancing 54% · moderate confidence

  • Passed Senate

    Current position in the legislative process.

  • 17 sponsors

    1 primary, 16 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 3 parties (9 R · 7 D · 1 I) — cross-party backing.

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

In plain language

The bill extends the rural community hospital demonstration program for an additional five years.

This legislation reauthorizes the rural community hospital demonstration program by extending it from a 15-year to a 20-year period. It includes amendments to ensure that certain rural hospitals can participate during specific timeframes.

Summary

Rural Community Hospital Demonstration Program ReauthorizationThis bill extends the Rural Community Hospital Demonstration Program for an additional five years. The program tests the feasibility of cost-based reimbursement under Medicare for small rural hospitals that are too large to qualify for special payment as critical access hospitals.The bill specifies that hospitals that participate in the program between December 30, 2024, and January 1, 2027, may continue to participate during the five-year extension period.

Bill Text

What changed in the latest version

6 added · 10 removed

Plain-language change summary

The bill S 4460 was amended to reflect its passage by the Senate on May 20, 2026, as indicated in the engrossed version. The reference to the bill being introduced on April 30, 2026, along with the list of sponsors, was removed. This change matters because it officially updates the bill's status and acknowledges its movement through the legislative process.

→
Previous
Latest
4460 Introduced in Senate (IS)] <DOC> 119th CONGRESS 2d Session S.
4460 Engrossed in Senate (ES)] <DOC> 119th CONGRESS 2d Session S.
4460 To provide for an extension of the rural community hospital demonstration program.
4460 _______________________________________________________________________ AN ACT To provide for an extension of the rural community hospital demonstration program.
_______________________________________________________________________ IN THE SENATE OF THE UNITED STATES April 30, 2026 Mr.
Grassley (for himself, Mr.
Bennet, Mr.
Crapo, Mr.
Wyden, Mr.
Sullivan, Mr.
Lujan, Mrs.
Hyde-Smith, Mr.
Welch, Mr.
Moran, Mr.
King, Ms.
Murkowski, Mr.
Merkley, Mr.
Ricketts, Mr.
Heinrich, Mr.
Lankford, and Mr.
Hickenlooper) introduced the following bill;
which was read twice and referred to the Committee on Finance _______________________________________________________________________ A BILL To provide for an extension of the rural community hospital demonstration program.
<all>
Passed the Senate May 20, 2026.
Attest:
Secretary.
119th CONGRESS 2d Session S.
4460 _______________________________________________________________________ AN ACT To provide for an extension of the rural community hospital demonstration program.
⬇ Download PDF
View plain text versions (2)

Action History

  1. Introduced in Senate

  2. Read twice and referred to the Committee on Finance.

  3. Senate Committee on Finance discharged by Unanimous Consent.

  4. Senate Committee on Finance discharged by Unanimous Consent.

  5. Passed/agreed to in Senate: Passed Senate without amendment by Unanimous Consent.

  6. Passed Senate without amendment by Unanimous Consent. (consideration: CR S2428; text: CR S2428)

  7. Message on Senate action sent to the House.

  8. Received in the House.

  9. Held at the desk.

Sponsors

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 16 co-sponsors · 530 not signed on

Sponsors (1)

Co-sponsors (16)

Not signed on (530)

530 members have not signed on to this bill.

Show all 530 →

"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

veterans healthcare
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does S 4460 do?
Rural Community Hospital Demonstration Program ReauthorizationThis bill extends the Rural Community Hospital Demonstration Program for an additional five years. The program tests the feasibility of cost-based reimbursement under Medicare for small rural hospitals that are too large to qualify for special payment as critical access hospitals.The bill specifies that hospitals that participate in the program between December 30, 2024, and January 1, 2027, may continue to participate during the five-year extension period.
Who sponsors S 4460?
S 4460 is sponsored by Bennet, Michael F. (Democratic), Crapo, Mike (Republican), Wyden, Ron (Democratic), Sullivan, Dan (Republican), Luján, Ben Ray (Democratic), Hyde-Smith, Cindy (Republican), Welch, Peter (Democratic), Moran, Jerry (Republican), King, Angus S., Jr. (Independent), Murkowski, Lisa (Republican), Merkley, Jeff (Democratic), Ricketts, Pete (Republican), Heinrich, Martin (Democratic), Lankford, James (Republican), Hickenlooper, John W. (Democratic), Fischer, Deb (Republican), and Grassley, Chuck (Republican).
What is the current status of S 4460?
This bill has passed the Senate. Introduced April 30, 2026. It now moves to the second chamber.
Where can I track S 4460?
Track S 4460 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on S 4460

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of S 4460

Last checked for changes 3 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →