The American Samoa Senate has rejected the administration's bill to fund the off island medical referral programme.
Concern about the added burden on the public of excise taxes on beer, other alcohol and cigarettes, and higher business licence fees was the main reason cited by opponents for rejecting the bill.
Two senators, Lualemaga Faoa and Pagofie Fiaigoa, say the burden to the public had been lightened with the House amendments to reduce the proposed hikes.
But the majority of the Senate spoke emphatically against the bill.
They say the Senate has approved separate funding for the hospital that wouldn't place any further burden on the public, namely through the refinancing of the Retirement Fund Loan.