More than two dozen hospitals across the country, most of them in Democratic congressional districts, would see their revenue boosted under a health insurance bill the House passed Wednesday.

Provisions in the bill (HR 3162), written by senior House Democrats, would change the formulas used to calculate Medicare reimbursements for at least 27 hospitals, in every case increasing the payments those institutions can expect from the entitlement, according to House Republican aides and health care lobbyists.

All but one of the hospitals are located in districts represented by Democrats, according to a spreadsheet compiled by House Republicans. Many of the districts are represented by senior members of the Energy and Commerce and the Ways and Means committees, which wrote the bill.

“I am very sure that individual hospitals are coming to these members and asking for these fixes,” a House Republican aide said. “It wasn’t an accident that these hospitals were singled out.”

When asked about the Republicans’ calculations, Yoni Cohen, a spokesman for Pete Stark, D-Calif., chairman of the House Ways and Means Health Subcommittee, said that the panel’s health staff aides were busy Wednesday and unavailable to discuss the hospital provisions.

The bill’s core is a $47.8 billion expansion, over five years, of the State Children’s Health Insurance Program, which covers about 6 million children whose families are low-income but not poor enough to qualify for Medicaid. But the bill also includes extensive sections concerning Medicare.

Taken in the context of the entire bill, which contains $86 billion in new spending over five years and $251 billion over 10 years, the Medicare reimbursement provisions are relatively inexpensive.

A bill section containing provisions affecting four cancer hospitals would cost $300 million over 10 years, according to the Congressional Budget Office (CBO). A section that would reclassify 19 hospitals into geographic areas that, under Medicare, are calculated to have higher labor costs and thus higher reimbursements would cost $600 million over 10 years.

Two other provisions, concerning reimbursements for two rural hospitals and the number of residents allowed to be employed at two other hospitals, would cost less than $50 million over 10 years, according to CBO.

The provisions do not identify the hospitals by name but sometimes go to extreme lengths to narrow the field of candidates.

One provision, for example, targets a hospital “located in a State that as of December 31, 2006, had only one center under section 15 414 of the Public Health Service Act that has been designated by the National Cancer Institute as a comprehensive center currently serving all 21 counties in the most densely populated State in the nation (U.S. Census estimate for 2005: 8,717,925 persons; 1,134.5 persons per square mile), serving more than 70,000 patient visits annually.” The hospital is the Cancer Institute of New Jersey.

The bill also includes a much broader provision, affecting more than 100 hospitals, according to lobbyists, that would extend for two years a program that allows hospitals to request inclusion in higher-wage areas for purposes of Medicare reimbursements.

Democrats say the provisions are intended to improve public health.

Frank Pallone Jr., D-N.J., chairman of the Energy and Commerce Subcommittee on Health, said the Cancer Institute of New Jersey asked him for the provision to help it fend off competition from hospitals in New York City and Philadelphia.

Pallone said Medicare pays the two other hospitals at a higher rate, and as a result, they have been able to “cherry-pick” wealthier patients in New Jersey. The bill would provide for the Cancer Institute to be paid at the same rate as its competitors.

New Jersey has one of the highest rates of cancer in the country, he noted. “We can’t be in a situation where the New Jersey Cancer Institute not only can’t compete but might be put out of business,” he said.

Another provision in the bill would designate a planned hospital in Butler, Ala., as a “Critical Access Hospital” under Medicare rules. “Critical Access” hospitals serve rural areas and normally must be at least 35 miles from any other hospital. Under the designation, Medicare pays the hospitals at a higher reimbursement rate than others in more urban areas, to encourage them to locate in places with low population densities.

The Butler hospital is in the district of Artur Davis, D-Ala., a member of the Ways and Means Committee.

“I am unapologetic about the fact I have been a champion of rural hospitals, and I have been a champion for hospitals in my district,” he said. One of his goals, he said, is to see a hospital built in every county in his district. The Butler hospital, he said, won’t be built without the “Critical Access” designation, to ensure it higher revenue.

None of the hospital provisions in the bill, he said, are inappropriate. “That’s part of why people sent us to Washington.”