Federal Cuts Threaten Rural Maternal Healthcare Access and Safety

Care will be in shorter supply, travel distances will stretch farther, and high-risk situations will more likely result in tragedy.

Rural mothers and newborns face significantly higher mortality and complications compared to urban areas, while federal actions may deepen these disparities. This dynamic signals a structural challenge in the availability and quality of maternal care in rural counties nationwide.

Between 2016 and 2019, maternal mortality was 81 percent higher in rural areas, with rural women nearly twice as likely to require hospital transfer during or after birth. Since 2005, 109 rural hospitals have closed, and over the past five years more than two per month shuttered labor-and-delivery units. As of 2023, 60 percent of rural counties had no hospital-based obstetric care. The Trump administration’s executive order raising H-1B visa costs to $100,000 and Medicaid cuts embedded in the One Big Beautiful Bill Act threaten to exacerbate workforce shortages and financial instability for rural hospitals that rely heavily on Medicaid, which covers over 40 percent of American births.

Many Medicaid cuts in the OBBBA are scheduled to take effect after this fall’s elections.

The government should define getting a healthy start in life as the entitlement of every American and therefore something that should be federalized like Medicare, with services reimbursed at a rate that keeps labor-and-delivery units and prenatal-care programs viable wherever they are needed. The future of a country quite literally depends on healthy births.

Rural America’s Maternal-Health Crisis Is About to Get Much Worse
By Keith Humphreys, The Atlantic