The One Big Beautiful Bill Act is set to have big implications for hospitals and insurers. But experts say it could also impact patient care—specifically, maternal health.
Already, the US has a D+ rating for maternal and infant mortality and morbidity, according to the 2024 March of Dimes Report Card. Now, the bill is cutting federal spending on Medicaid and the Children’s Health Insurance Program (CHIP) by $1 trillion, leaving 16 million beneficiaries potentially without coverage by 2034.
This is a challenge, as Medicaid is the largest single payer for pregnancy-related services, KFF reported in May, covering 41% of births across the country and nearly half of births in rural areas. States with the most rural hospitals are also more likely to have reproductive rights restrictions. (For example, Alabama, Oklahoma, and Texas all have abortion bans and are experiencing a rural health crisis.)
“Medicaid is vital for moms and babies in this country,” Michael Warren, chief medical and health officer at nonprofit March of Dimes, told Healthcare Brew.
Additionally, there’s a growing fear Medicaid cuts will spell the end of some rural maternal care units or entire facilities, experts previously told Healthcare Brew. When hospitals close services, birthing units can be some of the first to go.
This means not only are there healthcare workers leaving—or not moving to—these states but there’s also likely to be more births in places where abortion isn’t allowed.
“We're at a moment where we need to be doing all we can to think about increasing access and helping people get healthier before pregnancy and have a healthy pregnancy,” Warren said. “Anything we do that takes our foot off the gas is not moving us in the right direction.”
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Zooming in. Planned Parenthood is one example of maternal health clinics that may be hit by cuts.
In late July, a Massachusetts federal judge ruled in favor of a preliminary injunction to stop Medicaid cuts from affecting Planned Parenthood, but the nonprofit organization is still on the chopping block for potential defunding.
Planned Parenthood has been reportedly “targeted” for providing abortions, but the centers provide more than reproductive care, offering preventative and primary care, Monica Skoko Rodríguez, director of medical standards production at Planned Parenthood, told us.
The organization also treats underserved populations, with 76% of 600 Planned Parenthood centers based in “rural or medically underserved areas,” according to a fact sheet.
If it were defunded, patients could lose access to care like cancer screenings and intimate partner violence screenings, she added, leaving them to turn to hospitals for care instead. Avoidable emergency department visits overall cost the healthcare system an estimated $32 billion each year, according to United Health.
“They are not going to be able to access [these resources] until things really spiral out of control, and that's where we see an overload in emergency care systems and hospital systems, when things would have been much better managed much earlier on and would have had much better outcomes for the patient and for the healthcare ecosystem at large,” Rodríguez said.