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S. 4233
U.S. Senate•In Senate Committee
Summary
S. 4233, the Save Struggling Hospitals Act, was introduced in the Senate on Mar 26, 2026 by Sen. Mark Warner (D) with 6 co-sponsors. It was referred to Finance, and last saw action on Mar 26, 2026: Read twice and referred to the Committee on Finance.
Record
Text
S. 4233 has 6 co-sponsors.
sb4233/introduced-in-senate.txt119 S4233 IS: Save Struggling Hospitals ActU.S. Senate2026-03-26text/xmlENPursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.II 119th CONGRESS 2d Session S. 4233 IN THE SENATE OF THE UNITED STATES March 26, 2026 Mr. Warner (for himself, Mrs. Blackburn , Mrs. Hyde-Smith , and Mr. Tuberville ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILLTo amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy.1.Short titleThis Act may be cited as the Save Struggling Hospitals Act .2.Codification of the Medicare low-wage index hospital policySection 1886(d)(3)(E) of the Social Security Act ( 42 U.S.C. 1395ww(d)(3)(E) ) is amended—(1)in clause (i), in the first sentence, by striking or (iv) and inserting , (iv), or (v) ; and(2)by adding at the end the following new clause:(v)Area wage index adjustment for low-wage hospitals(I)In generalFor discharges occurring on or after October 1, 2019, the area wage index applicable under this subparagraph for a fiscal year to a hospital with an area wage index (determined without regard to this clause) below the 25th percentile area wage index shall be increased by ½ of the difference between the otherwise applicable final area wage index for such fiscal year for such hospital and the 25th percentile area wage index for such fiscal year across all hospitals.(II)Budget neutralityPursuant to the fourth sentence of clause (i), this clause shall be applied in a budget neutral manner. Any adjustments made for the purposes of such application of budget neutrality may not—(aa)decrease the area wage index applicable under this subparagraph to a hospital with an area wage index (determined without regard to this clause) below the 75th percentile area wage index for the fiscal year; or(bb)result in an area wage index applicable under this subparagraph to a hospital for such fiscal year that is less than 95 percent of the area wage index applicable under this subparagraph to such hospital for the preceding fiscal year..
Tracker
The tracker indicates the progress of this legislation as it moves through the legislative process.
- Introduced2026-03-26
- Passed Senate
- Passed House
- Conference
- To President
- Became Law
A bill to amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy.
Sponsors
Sen. Mark Warner (D) sponsors S. 4233, and 6 members have co-sponsored it, 3 of them from the day it was introduced.

Sen. · D–VA · Sponsor
Introduced Mar 26, 2026

Sen. · R–TN · Co-sponsor
Joined Mar 26, 2026 · Original

Sen. · R–MS · Co-sponsor
Joined Mar 26, 2026 · Original

Sen. · R–AL · Co-sponsor
Joined Mar 26, 2026 · Original

Sen. · R–TN · Co-sponsor
Joined Apr 22, 2026

Sen. · R–AR · Co-sponsor
Joined May 11, 2026

Sen. · R–MS · Co-sponsor
Joined Jul 16, 2026
Committees
S. 4233 went before 1 committee: Finance.
Actions
S. 4233 has taken 2 actions since Mar 26, 2026.
| Chamber | Action | |||
|---|---|---|---|---|
Mar 26, 2026 | Senate | Read twice and referred to the Committee on Finance.Finance Committee | ||
Mar 26, 2026 | — | Introduced in Senate |
Votes
S. 4233 has not gone to a roll call.
Related bills
1 bill is related to S. 4233, as Identical bill.
Titles
S. 4233 goes by 3 titles, 1 of them short titles.
- Save Struggling Hospitals Act — Display Title
- Save Struggling Hospitals Act — Short Title(s) as Introduced
- A bill to amend title XVIII of the Social Security Act to codify the Medicare low-wage index hospital policy. — Official Title as Introduced
Lobbying
2 clients hired 2 firms and 2 registered lobbyists who named S. 4233 in 8 quarterly filings, 2025 to 2026. Reported under the Lobbying Disclosure Act; a filing’s income covers everything its registrant worked that quarter, so the amounts below are the filings’, not this bill’s.
Filed under Budget/Appropriations, Natural Resources, Health Issues.
Clients
Who paid to be heard, by how many filings named the bill.
| Client | Business | State | Firms | Filings | Reported |
|---|---|---|---|---|---|
| GERING FT. LARAMIE IRRIGATION DISTRICT | Irrigation District | Nebraska | 1 | 6 | — |
| BALLAD HEALTH | Integrated health system | Tennessee | 1 | 2 | $100K |
Firms
Registrants who filed on the bill, by filings.
| Registrant | Clients | Filings | Reported |
|---|---|---|---|
| THE FERGUSON GROUP, LLC | 1 | 6 | — |
| DB3, LLC (FKA THE DASCHLE GROUP) | 1 | 2 | $100K |
Lobbyists
Named on the filings that cite the bill.
| Lobbyist | Firms | Clients | Filings |
|---|---|---|---|
| MARK LIMBAUGH | 1 | 1 | 6 |
| NICOLE CARELLI | 1 | 1 | 2 |
Filings
The documents themselves, on the Senate’s Lobbying Disclosure site, largest reported first.
| Client | Registrant | Period | Reported | Document |
|---|---|---|---|---|
| BALLAD HEALTH | DB3, LLC (FKA THE DASCHLE GROUP) | 2026 second_quarter | $50K | 2nd Quarter - Report |
| BALLAD HEALTH | DB3, LLC (FKA THE DASCHLE GROUP) | 2026 first_quarter | $50K | 1st Quarter - Report |
| GERING FT. LARAMIE IRRIGATION DISTRICT | THE FERGUSON GROUP, LLC | 2026 second_quarter | — | 2nd Quarter - Report |
| GERING FT. LARAMIE IRRIGATION DISTRICT | THE FERGUSON GROUP, LLC | 2026 first_quarter | — | 1st Quarter - Report |
| GERING FT. LARAMIE IRRIGATION DISTRICT | THE FERGUSON GROUP, LLC | 2025 fourth_quarter | — | 4th Quarter - Report |
| GERING FT. LARAMIE IRRIGATION DISTRICT | THE FERGUSON GROUP, LLC | 2025 third_quarter | — | 3rd Quarter - Report |
| GERING FT. LARAMIE IRRIGATION DISTRICT | THE FERGUSON GROUP, LLC | 2025 second_quarter | — | 2nd Quarter - Report |
| GERING FT. LARAMIE IRRIGATION DISTRICT | THE FERGUSON GROUP, LLC | 2025 first_quarter | — | 1st Quarter - Report |
Classification
The Congressional Research Service files S. 4233 under Health, one of its 31 policy areas.
CRS Subjects
CRS assigns every bill one policy area from its 31; S. 4233’s is Health.
s4233/policy-areas.txtSource: congress.gov · legiscan.com
