# 119-hr-7145: To amend title XIX of the Social Security Act to establish a definition of essential health system in statute and for other related purposes.

119-hr-7145, To amend title XIX of the Social Security Act to establish a definition of essential health system in statute and for other related purposes., is a 119th Congress bill sponsored by Rep. Trahan, Lori [D-MA-3] (D-MA); status introduced; PRIA reads it as touching household money (as of 2026-10-03).

- Canonical: https://policyrisk.com/legislation/119-hr-7145
- As of: 2026-10-03
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-7145
- Congress: 119
- Title: To amend title XIX of the Social Security Act to establish a definition of essential health system in statute and for other related purposes.
- Status: introduced
- Introduced: 2026-01-16
- Sponsor: Rep. Trahan, Lori [D-MA-3] (D-MA)
- Cosponsors: 25
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-03

## Summary

**Essential health system designation.** This bill would create a statutory definition and a five-year designation for hospitals that serve high shares of Medicaid and other low-income patients and would require the Medicaid and CHIP Payment and Access Commission (MACPAC) to publish an annual EHS index and list for Congress. - Hospitals: Hospitals that meet specified thresholds for Medicaid/low-income Medicare share or uncompensated care — including a Medicare disproportionate patient percentage of at least 35 percent or an uncompensated care payment factor threshold — would qualify as an essential health system if they meet at least one criterion in two of the three most recent fiscal years. Designation lasts five years and is subject to five-year redesignation periods. - Low-income patients and communities: Hospitals labeled as EHS would be highlighted for targeted payment and policy support aimed at preserving access to essential community services for low-income patients. - MACPAC and policymakers: The Medicaid and CHIP Payment and Access Commission would have to publish percentile EHS index values that rank hospitals within core-based statistical areas, states, and nationally, report a composite score, and submit a list of EHS hospitals to Congress starting within six months and then by August 1 each year.

## Cosponsors (25)

- Rep. Clarke, Yvette D. [D-NY-9] (D-NY), 2026-10-01T00:00:00.000Z
- Rep. Wittman, Robert J. [R-VA-1] (R-VA), 2026-10-01T00:00:00.000Z
- Rep. Valadao, David G. [R-CA-22] (R-CA), 2026-01-16T00:00:00.000Z
- Rep. Ciscomani, Juan [R-AZ-6] (R-AZ), 2026-01-16T00:00:00.000Z
- Rep. Carter, Troy A. [D-LA-2] (D-LA), 2026-01-16T00:00:00.000Z
- Rep. Veasey, Marc A. [D-TX-33] (D-TX), 2026-01-16T00:00:00.000Z
- Rep. Soto, Darren [D-FL-9] (D-FL), 2026-01-16T00:00:00.000Z
- Rep. Kiggans, Jennifer A. [R-VA-2] (R-VA), 2026-02-04T00:00:00.000Z
- Rep. Pettersen, Brittany [D-CO-7] (D-CO), 2026-02-04T00:00:00.000Z
- Rep. Bilirakis, Gus M. [R-FL-12] (R-FL), 2026-03-26T00:00:00.000Z
- Rep. Torres, Ritchie [D-NY-15] (D-NY), 2026-04-22T00:00:00.000Z
- Rep. Wagner, Ann [R-MO-2] (R-MO), 2026-04-22T00:00:00.000Z
- Rep. Owens, Burgess [R-UT-4] (R-UT), 2026-04-22T00:00:00.000Z
- Rep. Cleaver, Emanuel [D-MO-5] (D-MO), 2026-04-22T00:00:00.000Z
- Rep. Sewell, Terri A. [D-AL-7] (D-AL), 2026-04-22T00:00:00.000Z
- Rep. Balderson, Troy [R-OH-12] (R-OH), 2026-05-12T00:00:00.000Z
- Rep. Kennedy, Timothy M. [D-NY-26] (D-NY), 2026-06-03T00:00:00.000Z
- Rep. Craig, Angie [D-MN-2] (D-MN), 2026-06-10T00:00:00.000Z
- Rep. McGovern, James P. [D-MA-2] (D-MA), 2026-06-10T00:00:00.000Z
- Rep. Vasquez, Gabe [D-NM-2] (D-NM), 2026-06-30T00:00:00.000Z
- Rep. Evans, Gabe [R-CO-8] (R-CO), 2026-08-03T00:00:00.000Z
- Rep. Langworthy, Nicholas A. [R-NY-23] (R-NY), 2026-08-10T00:00:00.000Z
- Rep. Jackson, Jonathan L. [D-IL-1] (D-IL), 2026-08-31T00:00:00.000Z
- Rep. Bresnahan, Robert P. [R-PA-8] (R-PA), 2026-09-02T00:00:00.000Z
- Rep. Dean, Madeleine [D-PA-4] (D-PA), 2026-09-14T00:00:00.000Z

## Provisions PRIA read

- New rules for hospitals serving low-income patients: benefit, medium. This bill would create a statutory label called "essential health system" for certain non‑Federal government or nonprofit hospitals that serve many low‑income patients. A hospital would qualify if, in at least 2 of the 3 most recent fiscal years, it met at least one test: (1) a Medicare disproporti…

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- 119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025
- 119-hr-2102: Major Richard Star Act
- 119-hr-909: Crime Victims Fund Stabilization Act of 2025
- 119-hr-4382: America’s Olympic and Paralympic Games Commemorative Coins Act

## Sources
- [119-hr-7145 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/7145)

## Related
- [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842)
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025](https://policyrisk.com/legislation/119-hr-3514)
- [119-hr-2102: Major Richard Star Act](https://policyrisk.com/legislation/119-hr-2102)
- [119-hr-909: Crime Victims Fund Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-909)
- [119-hr-4382: America’s Olympic and Paralympic Games Commemorative Coins Act](https://policyrisk.com/legislation/119-hr-4382)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-7145 (as of 2026-10-03).