Republican wrote the fix. Cosponsor S. 2279 to Save Hospitals

Federal agencies should answer states by a deadline, and no hospital should lose funding because a review is slow. That holds no matter who runs Washington. Cosponsor the Protect Medicaid and Rural Hospitals Act (S. 2279) and write a decision deadline for Medicaid payment approvals into the FY2027 Labor-HHS appropriations bill. Here's the problem. CMS now takes up to a year to approve state directed payment applications, the supplemental funding hospitals use to cover the gap between Medicaid rates and the actual cost of care. Florida filed in May 2025 and waited roughly 11 months for approval of $7.8 billion, even with its Republican congressional delegation pushing. Texas hospitals began losing about $27 million a day on September 1, 2026, with $9.8 billion withheld, per the Texas Tribune. Gov. Greg Abbott, a Republican, called the holdup an economic gun to the head. Delay is not neutral. Under CMS guidance issued February 2, 2026, payments already approved are grandfathered under H.R. 1 while pending applications are not, so every month of agency silence moves a state closer to permanently losing its payment level. Grandfathered amounts begin dropping at least 10 percentage points a year on January 1, 2028. The stakes reach every district. CBO scored H.R. 1 at $1.02 trillion in Medicaid reductions through 2034, with 11.8 million more people uninsured. The Bipartisan Policy Center estimates rural areas lose $155 billion over ten years, and more than 16 million Medicaid enrollees live in rural communities. The $50 billion Rural Health Transformation Program covers less than a third of that gap. When the money stops, hospitals don't drop Medicaid patients. They close labor and delivery units, psychiatric beds, or the whole rural hospital, and everyone in the county loses access, insured or not. Three actions. Cosponsor S. 2279, filed by Republican Senator Josh Hawley to repeal the provider tax and directed payment changes in sections 71115 and 71116 of H.R. 1, or introduce its House companion. Require CMS to decide directed payment applications within 90 days and keep paying at the last approved rate during review, starting in the FY2027 Labor-HHS bill. And hold a hearing in Senate Finance or House Energy and Commerce on why these approvals take most of a year. A deadline for a federal agency is not a partisan idea. Pass one.