# Summary of S. 5236: Keeping Obstetrics Local Act
This legislation aims to support rural and safety net hospitals that provide maternity and childbirth services by increasing payment rates and expanding maternal health coverage under Medicaid and the Children's Health Insurance Program (CHIP).
The bill requires states to study the actual costs of providing maternity, labor, and delivery services and mandates that Medicaid payments to eligible hospitals—primarily rural hospitals and those serving low-income populations—be at or least 150 percent of Medicare rates starting in 2026. The federal government will cover 100 percent of the increased payment amounts. Additionally, the bill creates "anchor payments" to low-volume obstetric hospitals (fewer than 300 births annually) to help sustain essential services, starting with a $1.2 million annual standby capacity payment plus $10,000 per delivery in fiscal year 2027, both indexed to inflation.
On the coverage side, the bill extends continuous Medicaid and CHIP coverage for pregnant individuals through the first 12 months after pregnancy ends, requires presumptive eligibility for pregnant women, and expands support for maternal mental health screening and services. States may establish "maternity health homes" offering coordinated care during pregnancy and the postpartum period, with the federal government paying 90 percent of costs during the first two years.
The legislation also addresses workforce challenges by authorizing $150 million annually for the Commissioned Corps to deploy medical personnel to areas facing obstetric service shortages and streamlines enrollment of out-of-state maternity providers. Finally, hospitals must notify communities 180 days before closing obstetric units and report detailed labor and delivery data to support informed decision-making.
Take Action
Your position
Add a comment
to comment on this bill.
Annotate the text
Highlight any passage on the Summary or Full Text tab to attach a note. Annotations appear on the Annotations tab.