Keeping Obstetrics Local Act

Key Points

• Requires states to pay certain rural and safety-net hospitals more for maternity, labor, and delivery care under Medicaid starting in 2027, aiming to keep local labor-and-delivery units open.
• Boosts federal support for those higher payments, including the federal government paying 100% of the “extra” amount above a state’s older baseline rate for eligible hospitals starting in late 2026.
• Creates extra “anchor payments” for very low-birth-volume hospitals starting in 2028, including a per-birth amount and a separate standby amount to help cover the cost of keeping staff and rooms ready 24/7.
• Expands Medicaid and children’s coverage so people who qualify while pregnant keep full benefits for 12 months after pregnancy ends, not just pregnancy-related care.
• Adds steps to improve access and oversight: easier Medicaid enrollment for nearby out-of-state maternity providers, more support for postpartum depression/anxiety screening, and required public notice before a hospital closes an obstetrics unit.