# PATCH Act (S. 1624) - Plain Language Summary

## What This Bill Does

The PATCH Act (Protecting Access To Care in Hawaii Act) modifies how Medicare pays physicians in Hawaii. Specifically, it establishes a minimum payment adjustment for doctors providing services in Hawaii by setting a "floor" on the work geographic index—a technical factor Medicare uses to adjust physician payment rates based on regional cost differences. Under this bill, starting January 1, 2026, if Hawaii's work geographic index would normally be calculated at less than 1.5, it will be artificially raised to 1.5. This means doctors in Hawaii would receive higher Medicare reimbursement rates than the formula would otherwise provide.

## Who Benefits and Who Pays

**Beneficiaries:** Physicians practicing in Hawaii would receive increased Medicare payments, which could help attract and retain doctors in the state. Patients in Hawaii may benefit from improved access to medical care if higher reimbursement rates encourage more doctors to practice there.

**Cost:** The bill explicitly states this change will NOT be applied in a "budget neutral manner," meaning it will increase overall Medicare spending rather than offsetting costs elsewhere. This additional expense would ultimately be borne by the federal government and taxpayers.

## Key Provision

The critical detail is that this is a **permanent floor, not a temporary adjustment**—once implemented, Hawaii's payment index cannot fall below 1.5 without further congressional action. This makes it a significant long-term commitment of federal healthcare dollars.