More rural hospital closures would mean long drives for pregnant women seeking obstetric care

A KFF analysis finds that in 14 states, losing the nearest rural hospital or its obstetric unit would force many Medicaid patients onto drives of an hour or more to reach inpatient maternity care, compared with a national median of 13 minutes in urban areas. Alaska, Nevada and North Dakota have the longest potential drives.

Researchers link the coming acceleration to the tax and spending law President Trump signed last summer, which cuts hospital payments and trims Medicaid enrollment through new work requirements. From 2010 to 2022, 238 rural hospitals closed obstetrics units against just 26 openings, and nearly half of rural counties already lack any hospital offering birth services.

A 2022 GAO report blamed low Medicaid reimbursement and provider recruitment struggles; KFF's Brittni Frederiksen said the new cuts could push already thin-margin hospitals over the edge. The U.S. already posts one of the worst maternal mortality rates among wealthy nations, double or triple the rate elsewhere, with worse outcomes for Medicaid patients specifically.

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