# 119-hr-10729: Long-Term Rural Health Investment Act of 2026

119-hr-10729, Long-Term Rural Health Investment Act of 2026, is a 119th Congress bill sponsored by Rep. Davids, Sharice [D-KS-3] (D-KS); status introduced; PRIA reads it as touching household money (as of 2026-10-11).

- Canonical: https://policyrisk.com/legislation/119-hr-10729
- As of: 2026-10-11
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-10729
- Congress: 119
- Title: Long-Term Rural Health Investment Act of 2026
- Status: introduced
- Introduced: 2026-10-05
- Sponsor: Rep. Davids, Sharice [D-KS-3] (D-KS)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-11

## Summary

**Caps state-directed Medicaid payments at 200% of Medicare or the State’s average commercial rate.** This bill would reshape how states design and report state-directed payments, add tighter definitions and reconciliation rules, and undo recent provider-tax provisions. - States would face a hard cap on state-directed payments at **200%** of a specified Medicare rate or the state-average commercial rate. Grandfathered payments would be reduced by **10%** each year until they meet the new cap. - Medicaid managed care organizations, prepaid inpatient health plans, and prepaid ambulatory health plans would see new payment mechanics. The bill would let states withhold part of a final capitation rate to pay an SDP separately and require reconciliation tied to historical utilization. - States would have to submit detailed SDP data to the Transformed Medicaid Statistical Information System (T-MSIS) beginning in **2027**, within one year after each rating period. Required data include total SDP dollars, provider and enrollee identifiers, amounts paid to providers, and procedure and diagnosis codes. The bill would also repeal provider-tax provisions from Public Law 119-21 and rescind the related appropriation.

## Provisions PRIA read

- Caps and phase-down for Medicaid payments: cost, medium. If enacted, the bill would cap certain State-directed Medicaid payments at 200% of a benchmark rate for services in rating periods starting January 1, 2030. The benchmark would be the published total Medicare rate when available or the State’s average commercial rate if no Medicare rate exists. If…
- States get more control over payments: mixed, medium. If enacted, the bill would let States condition State-directed payments on service use outside the rating period for which approval is sought and require reconciliation to actual use during the rating period. If enacted, the bill would let States withhold part of a plan’s final capitation rate and…
- Repeal Medicaid provider-tax rules: mixed, medium. If enacted, the bill would repeal sections 71115 and 71117 of Public Law 119-21 and direct that section 1903(w) of the Social Security Act be applied as if those sections had not been enacted. The repeal would take effect on enactment. If enacted, the bill would also rescind the amounts appropriate…
- New reporting rules for Medicaid payments: mixed, low. If enacted, each State would have to submit detailed State-directed payment data starting January 1, 2027. If enacted, reports would be due within one year after each rating period and sent through the Transformed Medicaid Statistical Information System (T-MSIS). The data would include total SDP sp…

## Related bills

- 119-hr-4669: FEMA Act of 2025
- 119-hr-7977: Energy Bills Relief Act
- 119-hr-7481: Department of Homeland Security Appropriations Act, 2026
- 119-hr-7973: Momnibus Act
- 119-hr-7853: PrEP Access and Coverage Act of 2026
- 119-hr-5862: American Energy Independence and Affordability Act

## Sources
- [119-hr-10729 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/10729)

## Related
- [119-hr-4669: FEMA Act of 2025](https://policyrisk.com/legislation/119-hr-4669)
- [119-hr-7977: Energy Bills Relief Act](https://policyrisk.com/legislation/119-hr-7977)
- [119-hr-7481: Department of Homeland Security Appropriations Act, 2026](https://policyrisk.com/legislation/119-hr-7481)
- [119-hr-7973: Momnibus Act](https://policyrisk.com/legislation/119-hr-7973)
- [119-hr-7853: PrEP Access and Coverage Act of 2026](https://policyrisk.com/legislation/119-hr-7853)
- [119-hr-5862: American Energy Independence and Affordability Act](https://policyrisk.com/legislation/119-hr-5862)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-10729 (as of 2026-10-11).