Senate Finance Committee Chair Ron Wyden (D-Ore.) and 15 Senate Democrats unveiled a June 17 draft of the Keeping Obstetric Local Act (PDF), legislation intended to respond to the closure of labor and delivery units in rural and underserved areas. The bill seeks to address the financial challenges that contribute to maternity ward closures — including high fixed operating costs, low birth volumes, workforce shortages, and inadequate reimbursement — by raising the base Medicaid payment rate for labor and delivery services at certain rural and high-need hospitals. In addition, the legislation seeks to address workforce challenges by introducing new flexibilities to deploy obstetric providers to communities where they are most urgently needed.
Many of the proposals included in the draft legislation mirror those outlined in the AAMC’s maternal health advocacy agenda, which called upon lawmakers to strengthen the maternity care workforce, address the financial challenges facing the hospital sector, and guarantee 12 months of postpartum coverage under Medicaid [refer to Washington Highlights, April 26].