06.17.24

Saving WA’s Rural Maternity Wards From Closure Is Aim of New Cantwell Bill

Nationwide, 1 in 4 rural hospitals have stopped delivering babies; WA closures since 2022 include hospitals in Toppenish and Bremerton

WASHINGTON, D.C. – Today, U.S. Senator Maria Cantwell (D-WA), Sen. Ron Wyden (D-OR), and 14 other Senate Democrats released new draft legislation - the Keep Obstetrics Local Act.

The bill would help stem the tide of labor and delivery unit closures in rural areas. Labor and delivery units are uniquely expensive to operate, because they must be staffed 24/7. This high fixed cost, combined with the relatively low number of births in rural areas, led nearly one out of every four rural U.S. hospitals to stop providing obstetrics services between 2011 and 2021.

“Recent labor and delivery ward closures in Toppenish and Bremerton are a wake-up call: Hospitals serving rural moms-to-be need more support,” said Sen. Cantwell. “This bill addresses the high cost of providing maternal care in rural communities so we can prevent future closures and ensure that all pregnant Washingtonians can give birth close to home. It's especially important that we act quickly to bolster our hospitals in Eastern Washington -- with labor and delivery wards shutting down in Idaho, more Idahoans may be forced to seek care in our state.”

“As a rural hospital in Washington State, Jefferson Healthcare delivers two babies or fewer in an average week, yet must be ready to address an obstetrical emergency twenty-four hours a day, 365 days a year,” said Tina Toner, Chief Nursing Officer of Jefferson Healthcare in Port Townsend. “We are the only maternity ward in Jefferson County, and the nearest labor and delivery unit is almost an hour drive away. Our maternity ward is a critical community service that we are deeply committed to maintaining, but because of the low volume of births and low reimbursement rates we lose over a million dollars a year. We are deeply grateful for Senator Cantwell’s comprehensive rural labor and delivery bill and believe that her ongoing commitment to preserving these necessary services in rural communities is paramount to ensuring that hospitals like Jefferson Healthcare can continue to take care of our community.” 

Naval Hospital Bremerton stopped delivering babies in April 2022, while the Family Maternity Center at Astria Health Toppenish Hospital closed in December of that year. Newport Hospital also closed its maternity ward in 2022, but reopened the next year after the closure of labor and maternity services at Bonner General Health in nearby Sandpoint, ID, created more community need. Providers throughout Eastern Washington have reported seeing an increase in patients traveling from Idaho to access the full range of reproductive health options.

The Keep Obstetrics Local Act would address the root causes of labor and delivery unit closures in rural areas by:

  • Increasing Medicaid payment rates for labor and delivery services with enhanced federal financing for eligible rural and high-need urban hospitals.
  • Creating low-volume payment adjustments for labor and delivery services at hospitals with low birth volumes.
  • Allowing obstetrics-trained providers from the U.S. Public Health Service to assist hospitals and states with urgent maternal health care needs, such as in cases of hospital closures.
  • Mandating that each state study and report the costs of providing labor and delivery services in its rural and medically underserved areas and report its results to the Department of Health and Human Services.

Approximately 25% of hospitals Washington state would qualify for increased Medicaid payments for labor and delivery services under the current parameters of the bill.

Other messages of support from rural WA hospitals: 

“Funding for labor and delivery operations is essential to stabilize these services in our rural community. As operational losses for labor and delivery services continue to rise, the sustainability of these services in rural settings is jeopardized.” -- Abby Smith, CFO, Whitman Hospital and Medical Clinics (Colfax)

“Astria Sunnyside Hospital is grateful to Senator Wyden and Senator Cantwell for their unwavering support and commitment to the health care needs of women in rural America. The Keep Obstetrics Local Act will improve the health outcomes of women and babies in our community and enable Astria Sunnyside Hospital to continue facilitating these critical services.” -- Brian Gibbons, CEO, Astria Health (Sunnyside)

“Preserving labor & delivery services is critical for rural communities -- thank you Senator Cantwell for addressing these issues facing rural healthcare.” -- Theresa Sullivan, CEO, Samaritan Healthcare (Moses Lake)

A summary and section by section of the draft legislation can be found here. Legislative text can be found here.

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