To amend titles XIX and XXI of the Social Security Act to enhance financial support for rural and safety net hospitals providing maternity, labor, and delivery services to vulnerable populations, and for other purposes.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
This bill significantly expands financial support for hospitals that provide maternity and delivery services, particularly rural and safety net hospitals that serve Medicaid and CHIP populations. It establishes minimum payment rates for these services, creates new 'anchor payments' to help low-volume obstetric hospitals maintain operations, and provides 100% federal matching funds for enhanced payment amounts.
Who Benefits and How
Rural and safety net hospitals benefit through guaranteed minimum payment rates (at least 100% of Medicare rates) and annual anchor payments to help cover fixed costs of maintaining delivery services. Pregnant women on Medicaid benefit from mandatory 12-month postpartum coverage, presumptive eligibility, and new 'maternity health homes' for coordinated care. Doulas, midwives, and maternal health professionals benefit from new guidance to improve Medicaid coverage for their services. States benefit from 100% federal matching for enhanced payments and increased FMAP rates.
Who Bears the Burden and How
States must conduct cost studies every 5 years and submit plan amendments by October 2025 to comply with new payment requirements. Hospitals must submit new data in cost reports about labor and delivery services, including birth counts, staffing, and revenue sources. Hospitals closing obstetric units must provide 180-day advance notice with community impact assessments.
Key Provisions
- Establishes minimum Medicaid payment rates (at least 100% of Medicare) for maternity services at eligible hospitals
- Creates anchor payments for low-volume obstetric hospitals to maintain delivery capacity
- Provides 100% federal matching for enhanced payment amounts
- Mandates 12-month continuous postpartum coverage under Medicaid
- Requires 180-day notice before hospital obstetric unit closures
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Enhances federal financial support for rural and safety net hospitals providing maternity, labor, and delivery services under Medicaid and CHIP by establishing minimum payment rates, anchor payments, and increased federal matching funds.
Key Policy Areas
Healthcare, Maternal Health, Medicaid, CHIP, Rural Healthcare, Hospital Reimbursement
Primary Purpose
Enhances federal financial support for rural and safety net hospitals providing maternity, labor, and delivery services under Medicaid and CHIP by establishing minimum payment rates, anchor payments, and increased federal matching funds.
Policy Domains
Title I - Coverage and Payments for Hospital Services
Identified Gains
Contextual inference, no direct clause citation- Rural hospitals
- Safety net hospitals
- Critical access hospitals
- States
- Pregnant women on Medicaid
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- States
- Federal government
Contextual inference, no direct clause citation
Title II - Eligibility and Services
Identified Gains
Contextual inference, no direct clause citation- Pregnant women on Medicaid
- Postpartum women
- Doulas and midwives
- Health care providers
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- States
Contextual inference, no direct clause citation
Title IV - Data Collection and Notifications
Identified Gains
Contextual inference, no direct clause citation- HHS
- State health agencies
- Communities
- Policymakers
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Hospitals
- Hospitals closing obstetric units
Contextual inference, no direct clause citation
Title III - Provider and Workforce Issues
Identified Gains
Contextual inference, no direct clause citation- Commissioned Corps officers
- Out-of-state maternal health providers
- Rural communities
- Pregnant women in underserved areas
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- States
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
IntroducedMr. Wyden (for himself, Ms. Hassan, Ms. Stabenow, Ms. Cantwell, …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Critical access hospitals, Eligible hospitals providing maternity services, Hospitals or facilities requesting workforce assistance
Positive-direction: Critical access hospitals, Eligible hospitals providing maternity services, Hospitals or facilities requesting workforce assistance, Hospitals providing maternity services to CHIP enrollees, Hospitals receiving disproportionate share payments, Hospitals serving underserved populations, Independent rural hospitals with under 300 births per year, Indian Health Service hospitals, Low-volume obstetric hospitals, Low-volume obstetric hospitals under 300 births per year, Rural hospitals providing obstetric services, Safety net hospitals, Safety net hospitals with 50%+ Medicaid births, Small rural obstetric hospitals
Negative-direction: Hospitals planning to close obstetric units, Hospitals providing labor and delivery services
Certified nurse midwives, Certified professional midwives, Community health workers and care coordinators
Communities facing loss of obstetric services, Postpartum women, Pregnant women enrolled in CHIP
State Medicaid agencies, State Medicaid programs, State health agencies
State Medicaid programs faces effects in multiple directions
Federal government, Healthcare policymakers and researchers, Public Health Service Commissioned Corps personnel
Positive-direction: Healthcare policymakers and researchers, Public Health Service Commissioned Corps personnel
Negative-direction: Federal government
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
Key Definitions
Terms defined in this bill
A maternal health care need arising from closure or imminent closure of a hospital or loss of maternal health care workers
A provider of maternity services in a neighboring state with low fraud risk that is enrolled in Medicare or the Medicaid program of a neighboring state
A designated provider, team of health care professionals, or health team providing pregnancy and postpartum coordinated care services to eligible individuals
Inpatient and outpatient hospital services, including behavioral health services, provided in relation to maternity care or labor and delivery, identified by appropriate ICD and CPT codes as specified by the Secretary
A hospital where at least 50% of births are financed by Medicaid or CHIP, or an independent rural hospital with less than 300 births per year, or a critical access hospital providing labor and delivery services
For FY2026, at least 100% of Medicare rates; for FY2027+, the higher of Medicare rates or the average allowable hospital cost for maternity services
Annual payment to low volume obstetric hospitals equal to labor and delivery revenue floor minus Medicaid labor and delivery revenue for the fiscal year
A hospital with delivery volume not exceeding the number specified by the Secretary (not less than 300 deliveries per year)
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology