119 S5112 IS: Health Over Wealth Act U.S. Senate 2026-07-23 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

II119th CONGRESS2d SessionS. 5112IN THE SENATE OF THE UNITED STATESJuly 23, 2026Mr. Markey (for himself, Mr. Sanders, Ms. Warren, Mr. Blumenthal, Mr. Merkley, Ms. Baldwin, Mr. Booker, and Ms. Smith) introduced the following bill; which was read twice and referred to the Committee on FinanceA BILLTo amend the Public Health Service Act to require the Secretary of Health and Human Services to enforce certain requirements with respect to for-profit corporations that own health care systems, and for other purposes.

1.

Short title

This Act may be cited as the Health Over Wealth Act.

2.

Amendment to the Public Health Service Act

The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the following:.

3.

Prohibited acts by investment companies with respect to health care

Section 12 of the Investment Company Act of 1940 (15 U.S.C. 80a–12) is amended by adding at the end the following:(h)(1)In this subsection, the term health care entity has the meaning given the term in section 3401 of the Public Health Service Act.(2)It shall be unlawful for any registered investment company to engage in any act, practice, or course of business that would strip an asset from a health care entity or otherwise undermine the quality or safety of, or access to, health care.(3)The Commission, in consultation with the Secretary of Health and Human Services, shall, for the purposes of this subsection, by rules and regulations define, and prescribe means reasonably designed to prevent, actions, practices, and courses of business described in paragraph (2)..

4.

Amendments to title 11, United States Code

(a)

Priorities of claims in bankruptcy

(1)

In general

Section 507(a) of title 11, United States Code, is amended—(A)by redesignating paragraphs (1) through 10 as paragraphs (2) through (11), respectively;(B)by inserting before paragraph (2), as so redesignated, the following:(1)First, withdrawal liability determined under part 1 of subtitle E of title IV of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1381 et seq.).;(C)in the matter preceding subparagraph (A) of paragraph (2), as so redesignated, by striking First: and inserting Second:;(D)in paragraph (3), as so redesignated, by striking Second, and inserting Third,;(E)in paragraph (4), as so redesignated, by striking Third, and inserting Fourth,;(F)in the matter preceding subparagraph (A) of paragraph (5), as so redesignated, by striking Fourth, and inserting Fifth,;(G)in the matter preceding subparagraph (A) of paragraph (6), as so redesignated, by striking Fifth, and inserting Sixth,;(H)in the matter preceding subparagraph (A) of paragraph (7), as so redesignated, by striking Sixth, and inserting Seventh,;(I)in paragraph (8), as so redesignated, by striking Seventh, and inserting Eighth,;(J)in the matter preceding subparagraph (A) of paragraph (9), as so redesignated, by striking Eighth, and inserting Ninth,;(K)in paragraph (10), as so redesignated, by striking Ninth, and inserting Tenth,; and(L)in paragraph (11), as so redesignated, by striking Tenth, and inserting Eleventh,.(2)

Technical and conforming amendments

(A)Section 502(i) of title 11, United States Code, is amended by striking section 507(a)(8) and inserting section 507(a)(9).(B)Section 503(b)(1)(B)(i) of title 11, United States Code, is amended by striking section 507(a)(8) and inserting section 507(a)(9).(C)Section 507(d) of title 11, United States Code, is amended by striking (a)(1), (a)(4), (a)(5), (a)(6), (a)(7), (a)(8) excluding subparagraph (F), or (a)(9) and inserting (a)(2), (a)(5), (a)(6), (a)(7), (a)(8), (a)(9) excluding subparagraph (F), or (a)(10).(D)Section 523(a)(1)(A) of title 11, United States Code, is amended by striking section 507(a)(3) or 507(a)(8) and inserting section 507(a)(4) or 507(a)(9).(E)Section 724 of title 11, United States Code, is amended—(i)in subsection (b)(2)—(I)by striking section 507(a)(1)(C) or 507(a)(2) and inserting section 507(a)(2)(C) or 507(a)(3); and(II)by striking 507(a)(1)(A), 507(a)(1)(B), 507(a)(3), 507(a)(4), 507(a)(5), 507(a)(6), or 507(a)(7) and inserting 507(a)(2)(A), 507(a)(2)(B), 507(a)(4), 507(a)(5), 507(a)(6), 507(a)(7), or 507(a)(8); and(ii)in subsection (f)—(I)in paragraph (1), by striking section 507(a)(4) and inserting section 507(a)(5); and(II)in paragraph (2), by striking section 507(a)(5) and inserting section 507(a)(6).(F)Section 726(b) of title 11, United States Code, is amended by striking paragraph (1), (2), (3), (4), (5), (6), (7), (8), (9), or (10) of section 507(a) and inserting paragraphs (2) through (11) of section 507(a).(G)Section 752(a) of title 11, United States Code, is amended by striking section 507(a)(2) and inserting section 507(a)(3).(H)Section 766 of title 11, United States Code, is amended—(i)in subsection (h), by striking section 507(a)(2) and inserting section 507(a)(3); and(ii)in subsection (i)—(I)in paragraph (1), by striking section 507(a)(2) and inserting section 507(a)(3); and(II)in paragraph (2), by striking section 507(a)(2) and inserting section 507(a)(3).(I)Section 901(a) of title 11, United States Code, is amended by striking 507(a)(2) and inserting 507(a)(3).(J)Section 943(b)(5) of title 11, United States Code, is amended by striking section 507(a)(2) and inserting section 507(a)(3).(K)Section 1123(a)(1) of title 11, United States Code, is amended by striking section 507(a)(2), 507(a)(3), or 507(a)(8) and inserting section 507(a)(3), 507(a)(4), or 507(a)(9).(L)Section 1129(a)(9) of title 11, United States Code, is amended—(i)in subparagraph (A), by striking section 507(a)(2) or 507(a)(3) and inserting section 507(a)(3) or 507(a)(4);(ii)in the matter preceding clause (i) of subparagraph (B), by striking section 507(a)(1), 507(a)(4), 507(a)(5), 507(a)(6), or 507(a)(7) and inserting section 507(a)(2), 507(a)(5), 507(a)(6), 507(a)(7), or 507(a)(8);(iii)in the matter preceding clause (i) of subparagraph (C), by striking section 507(a)(8) and inserting section 507(a)(9); and(iv)in subparagraph (D), by striking section 507(a)(8) and inserting section 507(a)(9).(M)Section 1191(e) of title 11, United States Code, is amended by striking paragraph (2) or (3) and inserting paragraph (3) or (4).(N)Section 1222(a)(4) of title 11, United States Code, is amended by striking section 507(a)(1)(B) and inserting 507(a)(2)(B).(O)Section 1226(b)(1) of title 11, United States Code, is amended by striking section 507(a)(2) and inserting section 507(a)(3).(P)Section 1322(a)(4) of title 11, United States Code, is amended by striking section 507(a)(1)(B) and inserting section 507(a)(2)(B).(Q)Section 1326(b)(1) of title 11, United States Code, is amended by striking section 507(a)(2) and inserting section 507(a)(3).(R)Section 1328(a)(2) of title 11, United States Code, is amended by striking section 507(a)(8)(C) and inserting section 507(a)(9)(C).(S)Section 6(e) of the Securities Investor Protection Act of 1970 (15 U.S.C. 78fff(e)) is amended, in the last sentence, by striking section 507(a)(2) and inserting section 507(a)(3).(b)

Confirmation of plan

Section 1129 of title 11, United States Code, is amended by adding at the end the following:(f)Notwithstanding any other provision of this section, if the debtor is a health care business, the court, in confirming a plan, shall give substantial weight to the extent to which the plan would allow for maintenance of regional health care access, quality and safety of health care provided regionally, and health care provider and staff retention regionally..

5.

Maintenance of health care access relating to hospital discontinuation of services or closure

Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is amended—(1)in subsection (a)(1)—(A)in subparagraph (X), by striking and at the end;(B)in subparagraph (Y)(ii)(V), by striking the period and inserting , and; and(C)by inserting after subparagraph (Y) the following new subparagraph:(Z)beginning 60 days after the date of the enactment of this subparagraph, in the case of a hospital, to comply with the requirements of subsection (l) (relating to discontinuation of services or closure).; and(2)by adding at the end the following new subsection:(l)

Requirements for hospitals relating to discontinuation of services or closure

(1)

Requirements

(A)

In general

For purposes of subsection (a)(1)(Z), except as provided in subparagraph (B), the requirements described in this subsection are that a hospital—(i)notify the Secretary, in accordance with paragraph (2), not less than 90 days prior to the discontinuation of services or full hospital closure;(ii)prohibit the discontinuation of essential services (as defined in paragraph (6)) during the notification period (as defined in such paragraph) unless there is a clear harm posed to patient or employee health or safety in the hospital continuing to furnish such services;(iii)respond to any inquiries by the Secretary relating to the implementation of this subsection, including the determination of essential services under paragraph (6)(C); and(iv)if applicable—(I)submit a mitigation plan and related information as described in paragraph (3); and(II)participate in the public comment and review process (including, if applicable, the alternative mitigation plan) described in paragraph (4).(B)

Application in case of catastrophic events

In the case where a discontinuation of services or closure of a hospital is due to an unforeseen catastrophic event (as defined by the Secretary), the requirements described in subparagraph (A) shall apply, except—(i)the hospital shall provide the notification under clause (i) of such subparagraph not later than 30 days after the catastrophic event or as soon as feasible as determined by the Secretary; and(ii)clause (ii) of such subparagraph (relating to prohibiting the discontinuation of services) shall not apply.(2)

Notification information

For purposes of paragraph (1)(A)(i), the notification under such paragraph shall include the following information with respect to a hospital:(A)

Discontinuation of services

In the case where the hospital is discontinuing services (without full hospital closure):(i)The services that will be discontinued and number of hospital beds impacted.(ii)The number of individuals furnished such services annually and a breakdown of the type of insurance used by such individuals for such services.(iii)The number of impacted employees and what labor organization represents them (and the contact information for such organization).(iv)The names and addresses of any organized health care coalitions and community groups that represent the communities impacted by the discontinuation of such services.(v)Alternative providers of such services, including provider type, contact information, and distance and transportation time by car and public transit from the hospital.(B)

Full hospital closure

In the case of full hospital closure:(i)Hospital ownership entities.(ii)The full extent of services that will no longer be furnished by the hospital.(iii)The number of individuals furnished services annually by the hospital, a description of the services furnished, and a breakdown of the type of insurance used by such individuals for such services.(iv)The number of impacted employees and, if applicable, what labor organizations represent them (and the contact information for each such organization).(v)The names and addresses of any organized health care coalitions and community groups that represent the communities impacted by the closure.(vi)Alternative providers, including provider type, contact information, and distance and transportation time by car and public transit from the hospital.(vii)Steps taken prior to the decision to close in order to avoid closure.(viii)Distribution of liquidation proceeds (cash or assets) or any payments (cash or assets) made to employees, owners, or contractors related to the closure.(3)

Submission of mitigation plan and related information for essential services

(A)

Notification by secretary

If the Secretary determines that the discontinuation of services or closure of an applicable hospital would negatively impact access to essential services, the Secretary shall notify the applicable hospital of such determination.(B)

Submission of mitigation plan and related information

If an applicable hospital receives a notification under subparagraph (A), the applicable hospital shall, not later than 15 days after receiving such notification, submit to the Secretary, the State health department, and the local department of public health—(i)a plan to—(I)preserve access to essential services for impacted communities through partnerships, commitments from surrounding facilities, transportation plan access, and preparation for surge response; and(II)support employees in transitioning to new positions within health care;(ii)information on workforce and public engagement to ensure awareness of the discontinuation of services or closure;(iii)a description of potential alternatives to the discontinuation of services or closure that the hospital considered and an explanation of why those alternatives are not a viable option; and(iv)a local market study to ascertain regional bed supply, payor mix distribution among all providers, demographic trends, and remaining health systems in the area.(C)

Public availability

The Secretary shall make a mitigation plan and related information submitted by an applicable hospital under this paragraph available to the public on the internet website of the Centers for Medicare & Medicaid Services.(4)

Public comment and review process; alternative mitigation plan

(A)

Public comment period

(i)

In general

The Secretary shall provide a public comment period of not less than 45 days with the opportunity to submit written comments regarding the impact of the potential discontinuation of services or closure of an applicable hospital.(ii)

Notice

Notice of the opportunity to submit comments shall be published in the Federal Register and distributed to—(I)providers of services and suppliers that may be impacted by the discontinuation of services or closure of the applicable hospital;(II)any labor organization that represents any subdivision of employees of the applicable hospital;(III)organized health care coalitions and community groups that represent the communities impacted by the discontinuation of services or closure;(IV)the State health agency; and(V)the local department of public health.(iii)

Recommendations of State health agency and local departments of public health

In reviewing a mitigation plan submitted by an applicable hospital under paragraph (3), the Secretary shall take into consideration any recommendations submitted by the State health agency and local departments of public health, as applicable, regarding whether such plan should be approved.(B)

Alternative mitigation plan

(i)

In general

If, after reviewing the mitigation plan submitted by an applicable hospital under paragraph (3) and the comments submitted during the public comment period under subparagraph (A) with respect to the discontinuation of services or closure of the applicable hospital, the Secretary finds that the discontinuation of services or closure of the applicable hospital would have a significant impact on access to essential services, the Secretary shall work with the applicable hospital or other providers of services and suppliers in the area, as appropriate, to develop and implement an alternative plan to the plan submitted by the applicable hospital under paragraph (3) (referred to in this subsection as the alternative mitigation plan) in order to ensure continued access to essential services, which may include an agreement to delay the discontinuation of services or closure of the applicable hospital until the alternative mitigation plan is complete.(ii)

Technical assistance

An alternative mitigation plan under clause (i) may include technical assistance or information on available funding mechanisms to support the furnishing of essential services.(iii)

Collaboration

The Secretary should, to the extent practicable, collaborate with State and municipal government officials in the development of an alternative mitigation plan under clause (i).(iv)

Public availability

The Secretary shall make any information submitted and the alternative mitigation plan developed under this paragraph available to the public on the internet website of the Centers for Medicare & Medicaid Services.(C)

Implementation

The Secretary shall promulgate regulations to detail the required response time by an applicable hospital and the speed of the review process under this paragraph in order to ensure that such process can be completed with respect to an applicable hospital prior to the proposed service discontinuation date or closure date of the applicable hospital.(D)

Prohibition

In the case where the Secretary finds that a hospital has violated the requirements of this subsection, the Secretary may prohibit the hospital and any hospital under the same hospital ownership entity from being eligible to enroll or reenroll under the program under this title under section 1866(j) until the earlier of—(i)the date that is 3 years after the date on which the hospital discontinues services or closes;(ii)the date on which the Secretary determines essential health services that were negatively impacted by the discontinuation or closure have been restored; or(iii)such time as the Secretary is satisfied with the mitigation plan submitted by the hospital under paragraph (3) or the alternative mitigation plan under paragraph (4).(5)

Annual reports

The Secretary shall submit an annual report to Congress on the discontinuation of services and full closure of hospitals. Each report submitted under the preceding sentence shall include—(A)a description of trends in the discontinuation of services and closures of hospitals, including hospital ownership type, geographic location, types of services furnished, demographic served, and insurance type;(B)an analysis of the impact of the discontinuation of services and closures on health care access and ability to meet surge demand due to emergency (such as a pandemic or climate disaster); and(C)recommendations for such administrative or legislative changes as the Secretary determines appropriate to preserve access to essential services nationwide.(6)

Definitions

In this subsection:(A)

Applicable hospital

The term applicable hospital means a hospital that submits a notification under paragraph (1)(A)(i) of a discontinuation of services or full hospital closure.(B)

Discontinuation

The term discontinuation may include any reduction or discontinuation of services furnished by an applicable hospital, including those that occur as part of a merger or acquisition agreement.(C)

Essential services

The term essential services means, with respect to an applicable hospital, services that are necessary for preserving health care access (as determined by the Secretary), including services for which the Secretary determines—(i)there are no equivalent services available within the same travel time;(ii)that loss of the services would result in meaningful reductions in surge capacity that will negatively impact access to services;(iii)that loss of the services would limit health care access for specific demographics of individuals based on sex, sexuality, race, nationality, age, or disability status;(iv)that loss of the services would have a meaningful impact on the ability of health systems to respond to impacts of climate change; or(v)there is a health or health care-related emergency declaration status applicable to the surrounding geographical area of the hospital on the date on which the hospital submits notification under paragraph (1)(A)(i) of a discontinuation of services or full hospital closure.(D)

Notification period

The term notification period means, with respect to an applicable hospital, the period beginning on the date on which the hospital submits notification under paragraph (1)(A)(i) of a discontinuation of services or full hospital closure and ending on the date of such discontinuation of services or closure.(7)

No preemption of state law

Nothing in subsection (a)(1)(Z) or this subsection shall be construed to limit any rights or remedies under State or local law relating to protecting access to essential services or reviewing proposed hospital closures or reduction of services..

6.

Treatment of rents from qualified health care property

(a)

In general

Section 856(d)(2) of the Internal Revenue Code of 1986 is amended by striking and at the end of subparagraph (B), by striking the period and inserting , and at the end of subparagraph (C), and by adding at the end the following new subparagraph:(D)notwithstanding paragraphs (4), (6), and (8), any amount received or accrued directly or indirectly from qualified health care property (as defined in subsection (e)(6)(D)(i))..(b)

Conforming amendments

(1)Section 856(d)(8)(B) of the Internal Revenue Code of 1986 is amended—(A)by striking or a qualified health care property (as defined in subsection (e)(6)(D)(i)), and(B)by striking qualified health care property or.(2)Section 856(d)(9) of such Code is amended—(A)by striking or a qualified health care property (as defined in subsection (e)(6)(D)(i)) in subparagraph (A),(B)by striking or qualified health care property each place it appears in subparagraph (A) and (B), and(C)by striking or qualified health care properties in subparagraph (A).(c)

Effective date

The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.