S. 5513 — Domestic Manufacturing Revitalization Act of 2026

This section establishes a pilot program requiring hospitals that received above-average Medicare payments over the prior 5 years to purchase at least 40 percent domestic personal protective equipment and medical consumables. The program reimburses those costs from dedicated funds and reduces Medicare payments by 2 to 8 percent for each year of noncompliance after the third year, with the reduction remaining in effect after the program ends.

This section establishes a 300 percent ad valorem duty on imports of specified personal protective equipment and medical consumables listed under 20 HTS subheadings. It phases in the increases as follows: 10 percent after 180 days, 25 percent after two years, 50 percent after four years, and the full amount after five years. The Secretary of the Treasury must transfer the additional duties collected each year to the Secretary of Health and Human Services.

This section establishes a personal protective equipment production credit under new section 45BB equal to $0.25 per N95 respirator, $0.10 per surgical mask, $0.05 per medical glove, $0.50 per surgical gown, and $250 per ventilator or other HHS-designated equipment, for items produced in the United States with at least 60 percent domestic content in 2026–2027 and 75 percent thereafter, certified to federal safety standards, and sold to unrelated persons. It also establishes a 20 percent personal protective equipment investment credit under new section 48F for qualified investments in PPE manufacturing facilities meeting the same domestic content thresholds, prohibits claiming both credits on the same property, adds both credits to the general business credit and investment credit, and terminates both after December 31, 2035.