Wyden and Hassan Lead Introduction of Legislation to Stop Labor and Delivery Unit Closures in Rural and Underserved Communities

September 27,2024

Wyden and Hassan Lead Introduction of Legislation to Stop Labor and Delivery Unit Closures in Rural and Underserved Communities

Bill Sponsored by 16 Senate Democrats Uses Medicaid Funding to Bolster Rural Hospitals, Keep Resources in Local Communities

Washington, D.C. - Senate Finance Committee Chair Ron Wyden, D-Ore., Senator Maggie Hassan, D-N.H., and 16 Senate Democrats today introduced legislation to address a rising trend of rural hospitals and hospitals in underserved areas closing their labor and delivery units with significant consequences for expectant parents, families, and their local communities.

"Too many rural communities have become maternity deserts, leaving families without access to care. It's time we reverse this trend and offer some stability to rural hospitals so they can keep their labor and delivery ward doors open," Wyden said. "This legislation will give rural hospitals the means to continue serving their communities, and ensures that large hospital chains can't exploit the funds for profit."

"No matter where they live, expectant moms deserve access to high-quality care to protect their health and the health of their babies," Hassan said. "As more maternity wards in rural areas of New Hampshire and in states across the country close, this important legislation will help give rural hospitals the resources that they need to support labor and delivery units and provide the high-quality care that women deserve, while also making it easier for more women to get postpartum care after they give birth."

Between 2012 and 2022, approximately one-quarter of all rural hospitals stopped providing obstetrics services, impacting 267 communities. This trend of closures is caused by several overlapping challenges, including the high fixed operating costs of these units, low volumes of births, and difficulties in attracting and retaining OB-trained clinical staff, all of which are made worse by inadequate reimbursement for labor and delivery services.

The bill, titled the Keeping Obstetrics Local Act (KOLA), would increase Medicaid payment rates for labor and delivery services for eligible rural and high-need urban hospitals, provide "standby" payments to cover the costs of staffing and maintaining an obstetrics unit at low-volume hospitals, create low-volume payment adjustments for labor and delivery services at hospitals with low birth volumes and require all states to provide postpartum coverage for women in Medicaid for 12 months, among other steps. The proposal makes sure that hospitals are required to use these additional resources to invest in the maternal healthcare needs of the local communities they serve.

Earlier this year, the Finance Committee held a hearing on challenges facing rural health care providers and their communities, including labor and delivery unit closures. Wyden also led the release of a discussion draft of the legislation in June.

The legislation has been endorsed by the American College of Nurse-Midwives, America's Essential Hospitals, Catholic Health Association, Community Catalyst, Families USA, Hospital Association of Oregon, National Partnership for Women & Families, National Rural Health Association, the Oregon Perinatal Collaborative, American College of Obstetricians and Gynecologists

Joining Wyden and Hassan to introduce the legislation are Senators Debbie Stabenow, D-Mich., Maria Cantwell, D-Wash., Tom Carper, D-Del., Ben Cardin, D-Md., Sherrod Brown, D-Ohio, Michael Bennet, D-Colo., Bob Casey Jr., D-Pa., Mark Warner, D-Va., Sheldon Whitehouse, D-R.I., Catherine Cortez Masto, D-Nev., Elizabeth Warren, D-Mass., George Helmy, D-N.J., Tammy Duckworth, D-Ill., Corey Booker, D-N.J., Patty Murray, D-Wash, and Jeff Merkley, D-Ore.

A summary and section by section of the bill can be found here. The bill text is here.

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