Keeping Obstetrics Local Act
Sponsored By: Senator Ron Wyden
Introduced
Summary
This bill would aim to _keep obstetric care local_ by setting minimum Medicaid payment rates, creating per-delivery anchor payments for low-volume hospitals, expanding continuous pregnancy coverage, and requiring detailed state cost studies and public reporting. It pairs targeted hospital payments with new care models and data collection to try to preserve local labor and delivery services.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 5 benefits, 0 costs, 0 mixed.
Longer Medicaid coverage after childbirth
If enacted, States would have to give full Medicaid or CHIP benefits to pregnant people for 12 months after pregnancy ends. States generally would start this rule one year after enactment, though States that need new State laws get more time. The bill would also require States to offer quick, temporary Medicaid coverage checks for pregnant people starting on enactment. If enacted, the federal match would rise for certain perinatal depression and anxiety screenings one year after enactment and CHIP’s enhanced match for those screenings would increase by 1 percentage point.
Higher Medicaid maternity payment floors
If enacted, States would have to pay eligible hospitals a minimum Medicaid rate for maternity, labor, and delivery starting in fiscal year 2027. For fiscal year 2027 the minimum would be 150% of the Medicare rate for the same services. The bill would also require States to complete detailed maternity cost studies within 24 months and every five years after that, and to expand hospital cost reports starting with periods on or after July 1, 2026. HHS would get $10 million and $3 million for FY2026 to help with the studies and implementation.
Low-volume hospital revenue floor
If enacted, low-volume obstetric hospitals would get an annual anchor payment if other payments fall short of a Medicaid revenue floor. For fiscal year 2028 the bill sets $10,000 per delivery and a $1,200,000 standby amount, indexed later. States must pay any shortfall within three months after the fiscal year, but hospitals must meet training and contract rules to receive funds.
Optional maternity health homes program
If enacted, States could set up maternity health homes to coordinate pregnancy and 12-month postpartum care starting Jan. 1, 2028. States would pay designated providers to coordinate medical, behavioral, and social supports. The bill would fund $50 million in planning grants for FY2027 to help States prepare.
Stronger support for maternity providers
If enacted, the bill would let the federal Commissioned Corps be sent to areas with urgent maternal care needs and would authorize $150 million per year starting in fiscal year 2027 for those operations. States would also have to allow eligible out-of-State maternity providers to enroll for five-year periods starting Jan. 1, 2028, with limited extra screening. HHS must issue guidance within a year on covering doulas and certain midwives. Hospitals would also have to give at least 180 days notice before closing an obstetric unit and submit a community impact report.
Sponsors & CoSponsors
Sponsor
Ron Wyden
OR • D
Cosponsors
Maggie Hassan
NH • D
Sponsored 6/12/2025
Maria Cantwell
WA • D
Sponsored 6/12/2025
Michael Bennet
CO • D
Sponsored 6/12/2025
Mark Warner
VA • D
Sponsored 6/12/2025
Sheldon Whitehouse
RI • D
Sponsored 6/12/2025
Catherine Cortez Masto
NV • D
Sponsored 6/12/2025
Elizabeth Warren
MA • D
Sponsored 6/12/2025
Bernie Sanders
VT • I
Sponsored 6/12/2025
Tina Smith
MN • D
Sponsored 6/12/2025
Sen. Luján, Ben Ray [D-NM]
NM • D
Sponsored 6/12/2025
Raphael Warnock
GA • D
Sponsored 6/12/2025
Peter Welch
VT • D
Sponsored 6/12/2025
Tammy Duckworth
IL • D
Sponsored 6/12/2025
Cory Booker
NJ • D
Sponsored 6/12/2025
Jeff Merkley
OR • D
Sponsored 6/12/2025
Patty Murray
WA • D
Sponsored 6/12/2025
Angus King
ME • I
Sponsored 6/12/2025
Martin Heinrich
NM • D
Sponsored 2/2/2026
Roll Call Votes
No roll call votes available for this bill.
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