Article
What the bill does
The House approved H.R. 6500 by a 370-48 vote on Sept. 1, after the Senate passed its version 90-6 on Aug. 8. Beyond keeping agencies open through Dec. 11, the measure would bar the Office of Management and Budget from finalizing its proposed overhaul of the Uniform Grants Regulation, and from issuing any similar measure, before that date.
Why the grant rule matters to hospitals
Hospitals and health systems are among the largest recipients of federal grants. The money supports research, residency and workforce programs, emergency preparedness, maternal and behavioral health, rural services and public health infrastructure. Many of these projects run for several years and involve hiring, equipment and partnerships that cannot be unwound quickly.
According to the American Hospital Association’s July 13 comments, the proposed rule would give agencies more room to change award terms midstream and to suspend or end funding when priorities shift or a national interest finding is made. It would also broaden termination authority and remove appeals for discretionary terminations. The AHA warned that this uncertainty could make boards reluctant to commit matching funds and could push rural, children’s and safety-net hospitals away from federal grants altogether. It also asked OMB to clarify whether programs such as the Medicare Rural Hospital Flexibility Program and Innovation Center model funding would be covered.
The AHA asked OMB to limit changes and terminations to cases of serious noncompliance, a change in law or narrowly defined emergencies, to apply new terms only to new awards, and to guarantee notice, a chance to respond and a formal appeal.
What to do before Dec. 11
- Map the portfolio. List each federal award, its remaining term, the positions it funds and any institutional match.
- Rank by risk. Identify awards that support core services, such as behavioral health or rural access, where a sudden end would affect patients.
- Plan for gaps. Decide which programs you would sustain with operating funds or philanthropy and which you would wind down.
- Review new commitments. Before accepting multiyear awards, have finance and legal review termination terms and the cost of exit.
- Stay engaged. Work with your state association as the rule’s future is debated in the next funding round.
Archive entry for Sep 5, 2026, added Nov. 11, 2026.