John C. Fremont Hospital, Mariposa, California

June 25, 2026 - WASHINGTON — On Wednesday, U.S. Senator Josh Hawley (R-Mo.) held a press conference to introduce the Rural Hospital Emergency Room Guarantee Act, which would ensure Americans living in rural areas have access to top-notch and close-to-home healthcare. Senator Maggie Hassan (D-N.H.) joins him as a lead cosponsor of this legislation. Nearly 200 rural hospitals have shut their doors since 2005, leaving millions stranded in the face of potential health emergencies. Senator Hawley’s bill would prevent further closures. 

“Americans in rural communities across the country are confronted with a concerning shortage of access to emergency medical care. In Missouri alone, 12 rural hospitals with emergency rooms have closed in as many years, and those that remain open are struggling to keep the lights on. Congress must act swiftly to protect the necessary emergency care hardworking rural families deserve,” said Senator Hawley.

“In an emergency, every minute can feel like an hour. As more rural hospitals close their doors, Americans living in rural communities have to drive further and further to get care in a crisis,” said Senator Hassan. “This bipartisan legislation provides federal funding directly to rural emergency rooms, helping them keep their doors open and also preserving these lifelines for millions of Americans living in rural communities nationwide.”

Since 2014, Missouri has lost more than a dozen rural hospitals, and the rural hospitals that can continue to operate are hanging on by a thread. Nearly half of Missouri’s existing rural hospitals currently operate at a loss and are at risk of closing. 

Most concerningly, one recent report concluded that nearly 20% of the rural hospitals in Missouri—accounting for at least 10 hospitals—are at immediate risk of closure. Senator Hawley’s new legislation would create the Rural Hospital Emergency Department Guarantee, which would provide 10 years of dedicated funding to keep emergency rooms in rural communities operational.

The Rural Hospital Emergency Room Guarantee Act will: 

• Create a dedicated, 10-year funding stream to keep emergency rooms in rural America open.
• Provide eligible rural hospitals a baseline distribution of $1,000,000 per year to support the normal operating expenses of their emergency rooms.  Additional funding will be available based on each hospital’s specific geographical, patient-injury, and financial characteristics.  
• Allow one-time emergency payments of up to $250,000 to any participating rural hospital that is at risk of immediate closure.
• Allow rural hospitals to receive this guaranteed funding without negatively affecting their eligibility for any other federal healthcare program, designation, grant, or funding.

Read the bill text for the Rural Hospital Emergency Room Guarantee Act here.

Source: Senator Josh Hawley