rural hospitals; stability assessment; distribution

SB 1534 requires rural hospitals (in counties under 500,000 people) that don’t provide at least two core services - like 24/7 obstetrics, trauma care, or neonatal intensive care - to pay a 4% assessment on patient revenue starting in 2027. The collected funds flow into a state rural safety net fund, which then distributes money exclusively to eligible hospitals in the same county that *do* offer two or more core services and serve at least 20% Medicaid or uninsured patients. Hospitals must annually report emergency department data to the state, which will be publicly posted. The bill directly affects rural hospitals based on service capacity and patient mix, aiming to stabilize critical care access through targeted funding.