Grassley Celebrates Senate Passage of His Bipartisan Rural Community Hospital Demonstration Reauthorization Act

WASHINGTON – Sen. Chuck Grassley (R-Iowa) is praising the Senate’s unanimous passage of his Rural Community Hospital Demonstration Reauthorization Act with Sen. Michael Bennet (D-Colo.). The legislation would extend the Rural Community Hospital Demonstration (RCHD) program for another five years. Rep. Randy Feenstra (R-Iowa) introduced companion legislation today in the House of Representatives. Video and a transcript of Grassley’s remarks on the Senate floor follow. Floor Remarks by Senator Chuck Grassley of Iowa Senate President Pro Tempore “ Rural Community Hospital Demonstration Reauthorization Act ” Thursday, May 21, 2026 VIDEO As I travel Iowa, the issue of rural healthcare comes up frequently. Living in rural Iowa, I understand the importance of my fellow Iowans having access to healthcare close to home. In pursuit of that goal, I’ve led the charge to protect and expand access to rural healthcare. And some of the items that I’ve worked on over the years would be extending telehealth flexibilities , extending the rural hospital programs like [the] Medicare-Dependent Hospital program and Low-Volume Hospital program. Also, enacting pharmacy benefit manager (PBM) reform and expanding access to rural pharmacies. And I hope that PBM reform leads to lower drug costs for all Iowans. And then, establishing the Rural Emergency Hospital (REH) program and establishing the $50 billion Rural Health Transformation Fund that was in the tax bill of last year. Most recently, I’ve introduced the Rural Community Hospital Demonstration Reauthorization Act , which extends this demonstration program for another five years. Since 2005, the Rural Community Hospital Demonstration program has supported what we call rural “tweener” hospitals and given policymakers insight into improving rural healthcare. Now, how do you get that name, “tweener hospitals?” They are hospitals like those that are too large to be classified as critical access hospitals, and yet still have and face low volume[s]. The program tests innovative hospital payment models under Medicare. Nationally, up to 30 hospitals can participate in this program. Iowa is fortunate enough to have four hospitals in this program. They are located in Fort Dodge, Grinnell, Newton and Spirit Lake. Until last year, the Centers for Medicare and Medicaid Services (CMS) underutilized the program by leaving spots open. I’m happy that the Trump administration acted at my urging to correct this. I recently visited one of these hospitals in Grinnell, Iowa. As a result of Grinnell Regional Medical Center’s participation in this demonstration program, the hospital has been able to improve access to mental health, maternal health and [recruit] more providers. The data shows that the demonstration program has benefited rural healthcare, generally. Hospitals in the program have significantly improved their margins and had higher capital investments. The program has also helped with staff retention and adding services. While Congress has extended the Rural Community Hospital Demonstration program before, we need to reauthorize it again to continue this important work. I’m glad to partner with a bipartisan group of 16 Senate colleagues to introduce the bill that reauthorizes the program. I’m happy to report that last night the Senate passed the Rural Community Hospital Demonstration Reauthorization Act . Now, I look forward to working with my House colleagues to make this law. -30-