Keeping Obstetrics Local Act

The Keeping Obstetrics Local Act aims to improve access to maternity care by requiring states to study costs of obstetric services and setting minimum Medicaid payment rates that are higher than current rates (starting at 150% of Medicare rates for 2026). It creates "anchor payments" for low-volume obstetric hospitals to help them stay open, requiring states to pay hospitals meeting specific criteria the difference between what they're paid and what they need to operate. The bill also mandates 12-month continuous coverage for pregnant individuals under Medicaid and CHIP, and requires hospitals to notify communities 180 days before closing obstetric units, including details on service impacts and steps to address gaps. These provisions directly affect rural hospitals, Medicaid/CHIP recipients, and pregnant individuals seeking obstetric care.