June 30, 2025

Reps. Tokuda, Begich Seek Fair Medicare Reimbursements for Hawaiʻi and Alaska

Washington, DC – Today, U.S. Representatives Jill Tokuda (D-HI-02) and Nick Begich (R-AK) introduced two bills to address Medicare underpayments for rural hospitals in Hawaiʻi and Alaska: the Save our Lone Emergency Services (SOLES) Act and the Ensuring Outpatient Quality for Rural States Act. These bills seek to ensure Medicare reimbursement rates reflect the unique challenges and tremendous disparities that significantly increase healthcare delivery costs in the noncontiguous states.

The SOLES Act would set a floor on Medicare payments to isolated community hospitals in Hawaiʻi and Alaska, ensuring these facilities have the financial stability to continue delivering essential health services. The Ensuring Outpatient Quality for Rural States Act would authorize a cost-of-living adjustment for Medicare-covered hospital outpatient services in these states. Together, these bills make sure the Centers for Medicare and Medicaid Services pay for the higher regional costs faced by remote healthcare facilities when determining reimbursement rates in these states.
 
“Providing quality healthcare in Hawaiʻi and Alaska costs more, whether it’s due to the geographic isolation, limited infrastructure, difficulty recruiting and retaining healthcare professionals, or the exceptionally high cost of living. Yet, Medicare continues to reimburse rural hospitals in the noncontiguous states at the same rate as those in the U.S. mainland making it especially difficult to deliver care to our remote communities,” said Rep. Tokuda, co-chair of the Bipartisan Rural Health Caucus. “I’m proud to join my colleague Representative Begich in introducing these bills to promote fair reimbursement rates and provide lasting support for healthcare providers in Hawaiʻi and Alaska. By aligning Medicare payments with the true costs of healthcare delivery in our states, we can strengthen our local health systems and ensure sustained access to care for our kupuna, no matter where they live.”
 
“Access to healthcare for those who live in rural and remote communities presents significant challenges especially in places like Alaska and Hawaii. For too long, Medicare reimbursement formulas have failed to reflect the true cost of delivering care. We must continue to look for innovative ways to provide better access to healthcare in states with large rural populations,” said Rep. Begich. “That’s why I am proud to introduce the SOLES Act with the support of Representative Tokuda and co-sponsor the Ensuring Outpatient Quality for Rural States Act, bills that recognize these challenges and take concrete steps to ensure that our rural hospitals and dedicated providers have the tools they need to provide access to quality care in rural areas. These bipartisan bills are essential to protecting access to critical inpatient and outpatient services for our rural communities.”
 
Text of the two bills can be found here.

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