Rural Hospital Revitalization Act of 2026

Zero‑interest loans for rural hospitals

If enacted, the bill would create a temporary USDA loan program that gives eligible rural hospitals 0% interest for the first five years to build or modernize facilities. To qualify, a hospital campus must be in a county with under 20,000 people, or be at least 35 miles from the nearest hospital (15 miles in mountainous or secondary‑road areas), or be a Critical Access Hospital or Rural Emergency Hospital. Hospitals must have been licensed in the community at least 30 years and meet basic financial tests (at least 30 days cash on hand and a projected debt‑service coverage ratio of 1.2), and loans cannot be for facilities significantly improved in the last 10 years. Borrowers must repay principal during the zero‑percent period on the Community Facilities schedule and amortize for no more than the facility life or 40 years. After five years the Secretary would assess finances and either refinance remaining principal into the Community Facilities program or allow one one‑time renewal (up to five years) in specified circumstances; recipients would be eligible for federal technical assistance during the zero‑percent period and any renewal. The Secretary would prioritize very sparsely populated service areas, projects not feasible under current Community Facilities terms, and hospitals where at least 50% of care is Medicare, Medicaid, or self‑pay.