Cortez Masto, Colleagues Introduce Legislation to Bolster & Keep Resources in Rural Hospitals

Washington, D.C. - U.S. Senators Catherine Cortez Masto (D-Nev.), Ron Wyden (D-Ore.), Maggie Hassan (D-N.H.), and 15 Senate Democrats today introduced the Keep Obstetrics Local Act, 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.

"Every new and expectant mom in rural Nevada should have access to high-quality maternity care," said Senator Cortez Masto. "Our legislation will help hospitals in remote and underserved communities provide essential services to moms and their babies. I'll continue working to ensure Nevada families can count on the care they need to stay healthy."

In Nevada, more than half of the counties do not have a birthing hospital. Only four out of 14 rural hospitals offer routine labor and delivery statewide. In Nye County, the largest geographic county in Nevada, there isn't a single hospital that offers obstetric care or OB-GYNs. In Elko County, there are more than 53,000 Nevadans, but only 5 practicing OB-GYNs in 2022. 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 Keep 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. This bill also makes sure that hospitals are required to use these additional resources to invest in the maternal healthcare needs of the local communities they serve.

Joining Sens. Cortez Masto, 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.), 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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