Emergency Care Improvement Act

The Emergency Care Improvement Act (HR3134), introduced on May 1, 2025, by Rep. Arrington (R-TX) with 14 cosponsors, proposes amending titles XVIII and XIX of the Social Security Act to provide Medicare and Medicaid coverage for services furnished by freestanding emergency centers (FECs). The bill is currently in the early legislative stage, having been referred to the Committee on Energy and Commerce and the Committee on Ways and Means. It is an authorization bill — it does not appropriate specific funds but rather creates eligibility for reimbursement under existing Medicare and Medicaid programs. Actual payment levels would be set through CMS rulemaking post-passage. The bill's findings specifically cite that 118 FECs, mostly in Texas, enrolled under a COVID-19 waiver and saved Medicare 21.8% in lower emergency care payments. The mechanism is straightforward: by adding FECs to the list of eligible providers under Medicare Part B and Medicaid, the bill opens a new reimbursement channel for services these facilities already provide. There is no direct appropriation — funding flows through existing Medicare/Medicaid trust fund mechanisms. The structural winners are hospital operators with owned or operated freestanding emergency centers, particularly those with Texas exposure where FEC density is highest. Tenet Healthcare ($THC) and HCA Healthcare ($HCA) are the two largest publicly traded operators with significant Texas FEC footprints. Both would benefit from converting currently uncompensated or lower-reimbursed emergency encounters into Medicare/Medicaid billable events. The bill does not create new costs for these operators beyond compliance with CMS enrollment requirements. Real market data shows $THC at $180.1 and $HCA at $434.78 as of April 29, 2026. Both have declined significantly over the last 7 days ($THC -4.37%, $HCA -8.28%) and 30 days ($THC -4.2%, $HCA -7.06%). These declines are unrelated to this bill — the legislation has been in committee since May 2025 with no recent activity. The price action reflects broader market or sector-specific factors, not legislative momentum for HR3134. Legislative timeline: As an early-stage bill referred to two committees, the path to passage requires committee hearings, markups, House floor vote, Senate companion introduction and passage, and presidential signature. No Senate companion bill has been identified. The 119th Congress runs through January 2027, giving the bill a narrow window for advancement. The Texas-centric sponsorship (lead sponsor is from TX-19, three of four initial cosponsors are Texas representatives) suggests strong regional but not national momentum.