This Act may be cited as the Domestic Manufacturing Revitalization Act of 2026.

Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.U.S. Code — Title 42, Section 1395 and followingView official source on GovInfo) is amended by inserting the following after section 1866G: 1866H. Pilot program incentivizing domestic purchases of personal protective equipment and medical consumables by certain hospitals (a) In general Not later than 2 years after the date of enactment of this section, the Secretary shall establish a pilot program (referred to in this section as the Program) that meets the requirements of this section to incentivize eligible hospitals (as defined in subsection (b)) to meet the domestic purchasing requirements (as described in subsection (c)). (b) Eligible hospitals defined (1) Eligible hospital In this section, subject to paragraph (3), the term eligible hospital means a hospital— (A) identified by the Secretary under paragraph (2); and (B) that agrees to meet the purchasing requirements described in subsection (c). (2) Identification The Secretary shall identify each hospital that, during the period beginning on the date that is 5 years prior to the date of enactment of this section and ending on the date of such enactment, received payment under this title in an amount greater than the average amount of payment received by hospitals under this title during such period. (c) Domestic purchasing requirement (1) In general Subject to paragraph (2), the domestic purchasing requirement described in this subsection is a requirement that not less than 40 percent of the personal protective equipment and medical consumables purchased by an eligible hospital that is participating in the Program shall be domestic products. (2) Percentage adjustment The Secretary may adjust the percentage described in paragraph (1) to account for instances of supply chain disruptions, natural disasters, or national emergencies, as determined by the Secretary. (3) Attestation for domestic products (A) Submission to eligible hospitals Each eligible hospital participating in the Program shall require the manufacturer of each medical consumable and personal protective equipment that the hospital relies on to meet the domestic purchase requirements described in this subsection to annually submit to the hospital an attestation form described in subparagraph (B) that such consumable or equipment is a domestic product. (B) Development of form The Secretary shall develop an attestation form in which a manufacturer described in subparagraph (A) shall attest under penalty of perjury that the medical consumable or personal protective equipment purchased by an eligible hospital is a domestic product. (4) Submission of data The Secretary shall require each eligible hospital participating in the Program, to submit as part of any cost report required under this title— (A) the total dollar amount and quantity of personal protective equipment and medical consumables purchased by such hospital during the cost reporting period that are domestic products; (B) the percentage of the total amount of personal protective equipment and medical consumables purchased by such hospital during the cost reporting period that are domestic products; and (C) each attestation form submitted to the hospital under paragraph (3)(A). (d) Decreased reimbursement rate (1) In general For discharges occurring after the third year of the Program, for each eligible hospital participating in the Program, the Secretary shall— (A) determine, using the data submitted under paragraph (4) of subsection (c), if such hospital met the purchasing requirements described in such subsection with respect to the preceding year; and (B) decrease the payment amount that would otherwise be made under the applicable payment system by the applicable percent (as defined in paragraph (2)). (2) Applicable percent defined In this subsection, the term applicable percent means with respect to an eligible hospital that failed to meet the purchasing requirements— (A) for 1 year, 2 percent; (B) for 2 years, 3 percent; (C) for 3 years, 4 percent; (D) for 4 years, 5 percent; (E) for 5 years, 6 percent; (F) for 6 years, 7 percent; and (G) for 7 years, 8 percent. (3) Length of decreased rate Any deduction in payment made pursuant to this subsection shall remain in effect after the termination of the Program. (e) Reimbursement of domestic products (1) In general For discharges occurring in each year of the Program, for each eligible hospital participating in the Program, the Secretary shall, from amounts transferred to the Secretary under section 3(c) of the Domestic Manufacturing Revitalization Act of 2026, annually reimburse such hospital the dollar amount submitted by such hospital pursuant to subsection (c)(4)(A). (2) Transfer to Federal Hospital Insurance Trust Fund After the Secretary reimburses each hospital under paragraph (1), the Secretary shall transfer any remaining amounts transferred to the Secretary under section 3(c) of the Domestic Manufacturing Revitalization Act of 2026, to the Federal Insurance Trust Fund under section 1817. (f) Voluntary participation by certain other hospitals The Secretary shall establish a process under which a hospital not identified by the Secretary under subsection (b)(2) may elect to participate in the Program. In the case where a hospital makes an election under the preceding sentence, the hospital shall be deemed to be an eligible hospital under this section. (g) Trade agreements and Buy American Act (1) In general The requirements of this section shall apply notwithstanding any requirements under the Government Procurement Agreement, any trade agreement to which the United States is a party, or waiver under chapter 83 of title 41, United States Code (commonly known as the Buy American Act). (2) Government Procurement Agreement defined For purposes of this subsection, the term Government Procurement Agreement means the Agreement on Government Procurement referred to in section 101(d)(17) of the Uruguay Round Agreements Act (19 U.S.C. 3511(d)(17)U.S. Code — Title 19, Section 3511(d)(17)View official source on GovInfo). (h) Additional definitions In this section: (1) Domestic product (A) In general (i) Definition Except as described in subparagraph (B), the term domestic product, with respect to a medical consumable or personal protective equipment, means such a consumable or equipment that meets the following requirements: (I) The final assembly or processing of such consumable or equipment occurs in the United States. (II) Not less than the applicable percent of the total cost of components (as defined in subparagraph (C)) of such consumable or equipment is from domestic content. (ii) Applicable percent For purposes of clause (i)(II), the term applicable percent means— (I) with respect to a year of the Program occurring before the fourth year of the Program, 60 percent; and (II) with respect to the fourth year and subsequent years of the Program, 75 percent. (B) Textile-based personal protective equipment With respect to textile-based personal protective equipment, such as masks, gowns, gloves, and other equipment determined appropriate by the Secretary, the term domestic product means such equipment that meets the following requirements: (i) Each stage of production of the textile-based personal protective equipment occurs in the United States. (ii) Each textile, fabric, or fiber that comprises such equipment is grown, reprocessed, reused, or produced in the United States. (C) Total cost of components For purposes of subparagraph (A), the term total cost of components means— (i) with respect to a component of a medical consumable or personal protective equipment purchased by the manufacturer of such consumable or equipment, the acquisition costs of such component, including transportation costs and any tariff or duty applicable to such component; and (ii) with respect to a component of such consumable or equipment manufactured by the manufacturer of such consumable or equipment, the manufacturing costs of such component, including transportation and overhead costs attributable to the component, minus any profit and final assembly cost attributable to the component. (2) Medical consumable The term medical consumable means— (A) a medical or surgical instrument such as a syringe, needle, infusion pump, forcep, and scalpel; (B) a medical or surgical supply, such as an intravenous bag, catheter, tracheostomy tube, anesthesia equipment, gauze, bandage, suture, and any diagnostic or laboratory reagent; and (C) any related part or component determined appropriate by the Secretary. (3) Personal protective equipment The term personal protective equipment means equipment used for the protection of individuals in a health care setting and includes a surgical mask, N95 respirator, glove, gown, and any other related medical part or component determined appropriate by the Secretary. (i) Implementation This section shall be implemented through notice and comment rulemaking. (j) Termination The Program shall terminate on the date that is 9 years after the date on which the Secretary implements the Program..

(a) In general The President, by proclamation, shall revise the Harmonized Tariff Schedule of the United States (in this section referred to as the HTS) to establish rates of duty for covered articles that are equivalent to 300 percent ad valorem. (b) Phase-In of duty increases The President, by proclamation, shall phase-in the application of the duty increases required by subsection (a) as follows: (1) On and after the date that is 180 days after the date of the enactment of this Act, 10 percent of the total duty increase with respect to an article shall apply. (2) On and after the date that is 2 years after such date of enactment, 25 percent of the total duty increase with respect to an article shall apply. (3) On and after the date that is 4 years after such date of enactment, 50 percent of the total duty increase with respect to an article shall apply. (4) On and after the date that is 5 years after such date of enactment, 100 percent of the total duty increase with respect to an article shall apply. (c) Transfer of amounts Not less frequently than annually, the Secretary of the Treasury shall transfer to the Secretary of Health and Human Services an amount equal to the amount of any additional duties collected pursuant to the increased duty rates under this section during the previous year. (d) Covered article defined In this section, the term covered article means an article under any of the following subheadings of the HTS: (1) 3005.10.50. (2) 3005.90.10. (3) 3005.90.50. (4) 3006.10.00. (5) 3822.11.00. (6) 3822.19.00. (7) 3923.29.00. (8) 3926.20.10. (9) 4015.12.00. (10) 6210.10.50. (11) 6307.90.98. (12) 9018.31.00. (13) 9018.32.00. (14) 9018.39.00. (15) 9018.90.30. (16) 9018.90.75. (17) 9018.90.80. (18) 9019.20.00. (19) 9020.00.60. (20) 9020.00.90.

(a) Production of qualified personal protective equipment (1) In general Subpart D of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by adding at the end the following new section: 45BB. Credit for production of qualified personal protective equipment (a) In general For purposes of section 38, the personal protective equipment production credit for any taxable year is an amount equal to the sum of the credit amounts determined under subsection (b) with respect to each item of qualified personal protective equipment which is— (1) produced by the taxpayer, and (2) during the taxable year, sold by such taxpayer to an unrelated person. (b) Credit amount The amount determined under this subsection with respect to any item of qualified personal protective equipment shall be equal to— (1) in the case of an N95 respirator mask, $0.25, (2) in the case of a surgical mask, $0.10, (3) in the case of a medical glove, $0.05, (4) in the case of a surgical gown, $0.50, and (5) in the case of a ventilator or any other major equipment which has been designated by the Secretary of Health and Human Services for purposes of this section, $250. (c) Qualified personal protective equipment For purposes of this section, the term qualified personal protective equipment means any tangible personal property which— (1) is described in subsection (b), (2) is produced in the United States, (3) consists of— (A) in the case of any equipment produced during calendar year 2026 or 2027, not less than 60 percent domestic content, and (B) in the case of any equipment produced after December 31, 2027, not less than 75 percent domestic content, and (4) has been certified by the Secretary of Health and Human Services as satisfying applicable Federal safety standards. (d) Termination This section shall not apply to any qualified personal protective equipment produced after December 31, 2035.. (2) Credit to be part of general business credit Subsection (b) of section 38 of such Code is amended by striking plus at the end of paragraph (40), by striking the period at the end of paragraph (41) and inserting, plus, and by adding at the end the following new paragraph: (42) the personal protective equipment production credit determined under section 45BB(a).. (b) Investment credit in lieu of production credit (1) In general Section 46 of the Internal Revenue Code of 1986 is amended by striking and at the end of paragraph (6), by striking the period at the end of paragraph (7) and inserting, and, and by adding at the end the following new paragraph: (8) the personal protective equipment investment credit.. (2) Personal protective equipment investment credit Subpart E of part IV of subchapter A of chapter 1 of such Code is amended by inserting after section 48E the following: 48F. Investment credit for personal protective equipment manufacturing property (a) In general For purposes of section 46, the personal protective equipment investment credit for any taxable year is an amount equal to 20 percent of the qualified investment for such taxable year with respect to any PPE manufacturing facility of a taxpayer. (b) Qualified investment (1) In general For purposes of subsection (a), the qualified investment with respect to any PPE manufacturing facility for any taxable year is the basis of any personal protective equipment manufacturing property placed in service by the taxpayer during such taxable year which is part of a PPE manufacturing facility. (2) Personal protective equipment manufacturing property (A) In general For purposes of this section, the term personal protective equipment manufacturing property means property— (i) which is tangible property, (ii) with respect to which depreciation (or amortization in lieu of depreciation) is allowable, (iii) which is— (I) constructed, reconstructed, or erected by the taxpayer, or (II) acquired by the taxpayer if the original use of such property commences with the taxpayer, (iv) which consists of— (I) in the case of any property placed in service during calendar year 2026 or 2027, not less than 60 percent domestic content, and (II) in the case of any property placed in service after December 31, 2027, not less than 75 percent domestic content, and (v) which is integral to the operation of the PPE manufacturing facility. (B) Buildings and structural components Rules similar to the rules under section 48D(b)(2)(B) shall apply for purposes of this paragraph. (3) PPE manufacturing facility For purposes of this section, the term PPE manufacturing facility means a facility located in the United States which is used predominately in the production of qualified personal protective equipment (as defined in section 45BB(c)). (c) Coordination with personal protective equipment production credit If a credit is allowed under this section for any taxable year with respect to any personal protective equipment manufacturing property placed in service by the taxpayer during such taxable year which is part of a PPE manufacturing facility, no credit shall be allowed under section 45BB for any qualified personal protective equipment (as defined in section 45BB(c)) which is produced at such PPE manufacturing facility. (d) Termination This section shall not apply to any personal protective equipment manufacturing property which is placed in service after December 31, 2035.. (c) Clerical amendments (1) The table of sections for subpart D of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by adding at the end the following new item: Sec. 45BB. Credit for production of qualified personal protective equipment.. (2) The table of sections for subpart E of part IV of subchapter A of chapter 1 of such Code is amended by adding at the end the following new item: Sec. 48F. Investment credit for personal protective equipment manufacturing property.. (d) Effective dates The amendments made by this section shall apply to qualified personal protective equipment produced, and personal protective equipment manufacturing property placed in service, after December 31, 2025.