Medicaid Cuts Threaten Pregnancy Services in Rural America
“When there’s a maternal health emergency, Jessica Wheat springs into action.
Alongside a group of specialized health providers at Research Medical Center in Kansas City, Wheat works fast to make sure patients are able to have their babies delivered safely or their children given critical treatment at the Level III neonatal intensive care unit on site.
“We have just an abundance of resources, and people that know what they’re doing,” the labor and delivery nurse said.
That abundance is coming to an end. Last month, HCA Midwest Health, which owns Research Medical Center, announced it was closing its obstetrics program and NICU. The umbrella company that runs HCA Midwest Health, which oversees multiple hospitals and related sites of care in nearly two dozen states, cited declining births at the hospital as part of its reasons for the closure.
Wheat is worried about the implications for local patients who often struggle to find transportation even across Kansas City. But she’s also concerned about the rural patients outside of the metro area.
“We tend to get smaller hospitals that will Life Flight bleeding moms or moms who are breech or moms who are having a hypertensive crisis,” she said. “We can do the emergency C-section — a lot of smaller hospitals do not have those capabilities. The farther they have to go, the more at risk they’re going to be for complications, even death.”
The availability of obstetrics care in America has been dwindling for years. That could accelerate now, as hospital leaders across the country warn that President Donald Trump’s massive cuts to Medicaid, the federal-state health insurance program for low-income Americans, could leave pregnant people in rural communities with vanishingly few options for medical care.
Obstetrics is one of the most expensive services provided by hospitals, especially in rural areas, which often see a larger portion of Medicaid patients. Nationwide, the program pays for about 40 percent of all births. With financial hits looming, hospitals are primed to close maternity wards first, and rural areas are particularly vulnerable.
“This is going to have an enormous impact,” said Dr. John Cullen, a family physician in Valdez, Alaska, a remote city of about 4,000 people. “Already we’re seeing OB deserts that are increasing in size, and after the passage of this bill those are going to be markedly worse — where people are going to have to drive hundreds of miles before they can get prenatal care, much less delivery.”
Read more at The 19th.