SAVE Act for Healthcare: Federal Crimes, Penalties, and Supporters

The Save Healthcare Workers Act is a bipartisan federal bill, introduced in May 2025 as S. 1600 in the Senate and H.R. 3178 in the House, that would make it a federal crime to knowingly assault hospital employees while they are working. A conviction could carry up to ten years in prison, rising to twenty years if the attacker uses a dangerous weapon, causes serious bodily injury, or acts during a declared public emergency.¹

Senators Cindy Hyde-Smith (R-Miss.) and Angus King (I-Maine) introduced S. 1600 on May 5, 2025.² Representatives Madeleine Dean (D-Pa.) and Mariannette Miller-Meeks (R-Iowa) introduced the House companion, H.R. 3178, the same day.³

What the Bill Would Criminalize

The legislation would add a new Section 120 to title 18 of the U.S. Code. The new offense would cover knowingly assaulting an individual who is employed by a hospital engaged in interstate commerce, while that person is on hospital grounds.¹

Two penalty tiers apply:

A standard offense is punishable by a fine, imprisonment for up to ten years, or both.
The maximum rises to twenty years when the assault involves a dangerous weapon, causes serious bodily injury, or occurs during a declared public emergency.

Sponsors describe the structure as parallel to existing federal protections for aviation workers. Under 18 U.S.C. § 37, violence at airports serving international civil aviation is a federal crime carrying up to twenty years in prison, or life if a death results.⁴ Hospital staff currently have no equivalent federal protection.⁵

The Disability Affirmative Defense

The bill carves out an affirmative defense for defendants whose conduct was a “direct manifestation” of a physical, mental, or intellectual disability, provided the person could not appreciate the wrongfulness of their actions at the time.¹ That carve-out matters in a hospital setting, where patients experiencing dementia, delirium, psychiatric crises, or the effects of a medical condition may lash out at staff without the culpable intent the statute requires.

Required Government Accountability Office Study

The bill also directs the Government Accountability Office to study how the new law affects workplace violence in healthcare settings and prosecution rates for assaults on hospital workers.⁵

Why Sponsors Say a Federal Law Is Needed

Healthcare workers experience workplace violence at rates well above other industries. The Bureau of Labor Statistics recorded 41,960 nonfatal workplace violence cases in the healthcare and social assistance industry during the 2021–2022 reporting period, accounting for nearly 73% of all such cases in private industry.⁶ A 2024 American College of Emergency Physicians poll found that 91% of emergency physicians reported being threatened or attacked in the prior year.⁷

Federal law addresses that risk only indirectly. The Occupational Safety and Health Administration has issued voluntary guidelines but never an enforceable standard specific to healthcare workplace violence, and the agency’s rulemaking on the subject was placed in “long-term action” status on the spring 2025 regulatory agenda, meaning no federal regulatory action is expected within twelve months.⁸ Some states have criminalized attacks on healthcare workers, but coverage varies widely. Sponsors argue a uniform federal penalty is needed to close that gap.

As Senator Hyde-Smith put it when introducing the bill, “I believe the federal government can help deter violence and keep our healthcare workers safe by establishing stronger penalties for those who assault hospital employees.”²

Who Supports the Bill

The American Hospital Association, which represents nearly 5,000 hospitals and health systems, endorsed S. 1600 on May 8, 2025, writing that “ensuring a safe and secure environment for our workforce is essential to providing quality care.”⁵

Other endorsers include the Emergency Nurses Association, the American College of Emergency Physicians, America’s Essential Hospitals, the Catholic Health Association, the American Organization for Nursing Leadership, the American Nurses Association, the Children’s Hospital Association, and the Maine and Mississippi state hospital associations.² Sally Weiss of the Maine Hospital Association said Maine hospitals report more than 300 workplace violence incidents each month, with half involving physical assaults, and argued the bill “would act as a deterrent and send a strong message … that the safety and wellbeing of health care workers matters.”⁹

How the 2025 Bill Differs From the Earlier SAVE Act

The idea first appeared in the 118th Congress as the Safety From Violence for Healthcare Employees Act, or SAVE Act. Representative Larry Bucshon (R-Ind.) introduced H.R. 2584 on April 13, 2023, and it attracted 126 bipartisan cosponsors before stalling without a committee vote.¹⁰¹¹ Senator Joe Manchin introduced the Senate version, S. 2768, in September 2023.¹²

The 2025 reintroduction keeps the same criminal-penalty structure but drops one significant element and adds another. The earlier version would have created a federal grant program authorizing $25 million per year through 2032 for violence prevention training, de-escalation programs, and security infrastructure such as surveillance systems and panic buttons.¹⁰ That grant program is not in the 2025 bill. In its place is the GAO study requirement described above.

A Separate Bill Takes a Different Approach

A different federal proposal, the Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 2531), is sometimes confused with the Save Healthcare Workers Act. Representative Joe Courtney (D-Conn.) introduced it on April 1, 2025.¹³ Rather than creating criminal penalties, Courtney’s bill would require OSHA to issue an enforceable safety standard forcing healthcare and social service employers to develop violence prevention plans, conduct risk assessments, investigate incidents, and train staff, with compliance tied to Medicare participation. It has passed the House twice in prior Congresses but never cleared the Senate.¹⁴ The Emergency Nurses Association backs both bills, treating the criminal and preventive approaches as complementary.¹⁵

Where the Bill Stands

Both S. 1600 and H.R. 3178 have been referred to the Judiciary Committees in their respective chambers.¹⁶ As of its committee listing, H.R. 3178 had attracted 64 cosponsors.¹⁷ Movement now depends on whether Judiciary Committee leadership in either chamber schedules a hearing or markup. The prior version drew 126 House cosponsors and still never received a committee vote, so broad endorsement has not translated into legislative action in the past.

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Senator Cindy Hyde-Smith. Save Healthcare Workers Act Bill Text
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Senator Cindy Hyde-Smith. Sens Hyde-Smith King Introduce Save Healthcare Workers Act
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Representative Madeleine Dean. Dean Miller-Meeks Introduce Bill to Protect Healthcare Workers
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Cornell Law Institute. 18 U.S. Code Section 37
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American Hospital Association. AHA Supports Senate Save Healthcare Workers Act S 1600
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Bureau of Labor Statistics. Workplace Violence 2021-2022
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American College of Emergency Physicians. When Emergency Physicians Regularly Fear Violence at Work Its Past Time for Change
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MedCity News. OSHAs Evolving Approach to Workplace Violence Prevention in Healthcare
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Senator Angus King. King Hyde-Smith Introduce Bill to Crack Down on Violence Against Health Care Workers
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Congress.gov. H.R. 2584 Text
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GovTrack. H.R. 2584 Cosponsors
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Congress.gov. S. 2768 Text
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Congress.gov. H.R. 2531 Workplace Violence Prevention for Health Care and Social Service Workers Act
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Representative Joe Courtney. Workplace Violence Prevention for Healthcare and Social Service Workers Act
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Emergency Nurses Association. ENA Continues Support Bills Combat Workplace Violence
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Emergency Nurses Association. Save Healthcare Workers Act One-Pager
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Congress.gov. H.R. 3178 Committees