Bill would set hospital buying targets and raise duties on listed imports

The Health and Human Services Secretary would establish a hospital purchasing pilot. The Secretary would identify hospitals whose payments under Medicare over the five years before enactment exceeded the average for hospitals during that period. Other hospitals could elect to participate. Hospitals identified by the Secretary would have to agree to participate; other hospitals could choose to join. The bill ties hospital reimbursements to amounts transferred from added duties collected under section 3. The Secretary would have to establish the pilot within two years after enactment. It would end nine years after it begins. Payment cuts could start after its third year and continue after the pilot ends.

The President would raise import duties on listed medical supplies and protective equipment. The duties would apply to imported articles in the listed tariff categories. The bill lists 20 tariff categories of articles, including masks, gloves, medical supplies, and equipment. Treasury would transfer the added duties collected each year to Health and Human Services. The first 10% of the total duty increase would apply 180 days after enactment; 25% after two years, 50% after four years, and the full increase after five years.

Taxpayers could claim credits for qualifying protective equipment production or factory property. Production credits would cover listed equipment such as masks, gloves, gowns, and ventilators. Investment credits would cover qualifying property at U.S. facilities used mainly to make that equipment. The production credit would cover listed equipment made in the United States, meeting domestic-content and federal safety rules, and sold to an unrelated buyer. The factory investment credit would equal 20% of qualifying property costs. A taxpayer could not claim both credits for equipment made at the same facility. The credits would apply to equipment produced and property placed in service after December 31, 2025. Neither would apply to equipment produced or property placed in service after December 31, 2035. Domestic-content thresholds rise after 2027.