S4460-119 · 119th Congress
Passed Senate
Rural Community Hospital Demonstration Program Reauthorization
Rural Community Hospital Demonstration Program Reauthorization This bill extends the Rural Community Hospital Demonstration Program for an additional five years. The program tests the feasibility of cost-based reimbursement under Medicare for small rural hospitals that are too large to qualify for special payment as critical access hospitals. The bill specifies that hospitals that participate in the program between December 30, 2024, and January 1, 2027, may continue to participate during the five-year extension period.
MONEY ON THIS BILL
Which donor industries fund each side of the vote — total contributions from that industry to those members, all cycles · plus lobbying activity in affected industries
⬆ YEA voters — top donor industries
No data yet.
⬇ NAY voters — top donor industries
No data yet.
◎ Lobbying activity by issue area
- health_services1,000 filings
Dollar figures are each industry's total contributions to those members across all tracked cycles — not money given for this specific bill. Statistical patterns in public records; correlation, not causation.
LOBBYING ON THIS BILL
6 federal lobbying reports name this bill in their activity descriptions · LDA disclosures
RURAL VOICES FOR CONSERVATION COALITION4 reports
NATIONAL MULTIFAMILY HOUSING COUNCIL INC1 report
AMERICAN HOSPITAL ASSOCIATION1 report
⟳ The revolving door — lobbyists on this bill with disclosed former government roles
Brett FulcerHill Professional Staff Member, House Transportation and Infrastructure Committee (3/2019 - 1/2023)
Madeline WadeSpecial Projects Director, Rep. Greg Walden (7/2012-2/2014)
“Covered position” is the former government job lobbyists must disclose by law (LDA §4). Prior service is stated on the filings; it carries no implication of wrongdoing. Full revolving-door board →
A report naming a bill means the organization disclosed lobbying activity on it — the disclosure does not state a position for or against.
VOTE BREAKDOWN
No recorded floor vote
Most bills never receive a recorded roll-call vote — they're referred to committee and don't advance to the floor. The sponsor and funding context on this page still tells you who is behind it and what industries have a stake.
SPONSORS
Chuck Grassley
R-IA · Primary
16 COSPONSORS
BIPARTISAN● 7 D● 8 R● 1 I
+10 more (see dot grid above)
SPONSOR FUNDING
Top industries funding Grassley
Party & Leadership21%
Party & Leadership 21% of classified donations
Health Services9%
Health Services 9% of classified donations
Single-Issue Advocacy8%
Single-Issue Advocacy 8% of classified donations
Lawyers & Lobbyists8%
Lawyers & Lobbyists 8% of classified donations
Agriculture7%
Agriculture 7% of classified donations
TRAIL AI
S 4460, the Rural Community Hospital Demonstration Program Reauthorization, sponsored by Senator Chuck Grassley of Iowa, reauthorizes a federal demonstration program for rural hospitals. The bill has passed the Senate and is currently awaiting further congressional action. Detailed voting data for the Senate passage is not yet available.
Based on public voting records. Does not imply causation.
TIMELINE
INTRODUCEDApr 30, 2026
PASSED SENATEMay 20, 2026
DATA SOURCES
Bill data: Congress.gov · 117th–119th Congress (2021–present)
Vote records: House Clerk / Senate · 2021–present
Reflects public records. Does not imply causation.