As part of CCF’s Rural Health Project, we continue to track the important role Medicaid plays in rural America. A recent research paper on hospitals and maternity care has some important insights, especially for parents in rural areas and small towns. KFF researchers found that 1 in 3 hospitals providing inpatient maternity care to Medicaid enrollees are in rural areas and are typically located more than 40 minutes away from the next closest in-state hospital providing inpatient maternity care. This means a closure of any one of these rural hospital inpatient maternity units translates immediately into significantly increased travel times for pregnant women trying to get to the hospital quickly. As Dr. Katy Backes Kozhimannil, a top expert on rural maternal health, said during a CCF webinar last year: “With each rural hospital that closes its obstetric unit, the closest one gets further and further away, and with that come risks for some of the folks that are already at the highest risks of maternal morbidity and mortality.
And since Medicaid covers almost 1 in 4 women of reproductive age in rural communities and finances nearly half of all births in rural communities, large cuts to Medicaid will put significant strain on maternity care. Since Congress passed the largest cuts to Medicaid in history last year in the budget reconciliation bill ( H.R.1), already strained rural hospitals providing maternity care can expect more financial pressure. Specifically, H.R. 1 makes changes to state Medicaid financing around provider taxes and state directed payments that are expected to result in significant Medicaid program cuts as states will be unable to replace much of these provider tax revenues.
Rural hospitals face many different financial pressures beyond the cuts to Medicaid in H.R. 1 of course. But you don’t have to be a parent to realize that supporting families with the easiest practical access to quality labor and delivery care is a public good that benefits not only rushed parents but society as a whole.
I’ll close with another quote from Dr. Backes Kozhimannil: “The effects on rural communities of a hospital closing its labor and delivery unit, or closing altogether, cannot be overstated. Every person and family in a community is affected by the loss of birth in that community. It can change the way a community sees itself when it’s a place where babies can no longer be born.”