52 Maternity Wards Have Closed Since HR1 Was Announced
52 maternity wards have closed in the United States since the HR1 bill was announced in July 2025, with eight more announcing upcoming closure. The count comes from a Protect Our Care analysis reported on Oct. 11, 2026. The Guardian
The figure updates an earlier Protect Our Care tally from August of 50 closures across 29 states, including California and New York. The most recent analysis puts the total at 52 closed and eight announced. Protect Our Care
HR1 will fully come into effect in the new year, as reported on Oct. 11, 2026. The bill will require many adults covered through Medicaid to meet new work requirements. Medicaid is the joint federal-state health program for people with low incomes. The bill will subject many adults covered through Medicaid to more frequent eligibility checks, meaning more regular reviews of who still qualifies. It will provide less federal funding for states for Medicaid.
Two of the closures have explicitly linked their decisions to federal policy. Centra Southside Community Hospital in Virginia permanently closed its maternity ward and cited upcoming federal Medicaid policy changes as a reason. St Mary’s Sacred Heart Hospital in rural northeast Georgia permanently closed its maternity ward and cited upcoming federal Medicaid policy changes as a reason.
About 40% of births in the US are paid for by Medicaid. The US maternal mortality rate is 17.9 deaths per 100,000 live births, according to the latest CDC figures.
March of Dimes identified 31 at-risk rural hospitals with labor and delivery services whose possible closure would leave 96 counties without a labor and delivery unit.
Closures predate HR1 by more than a decade. Half of U.S. hospitals lack maternity wards. Over 700 hospitals shuttered their maternity wards between 2010 to 2024, with rural areas hit hardest. Healthcare Dive More than 200 maternity wards closed between 2004 and 2014 because of higher costs, fewer births and staffing shortages. Reuters Protect Our Care’s Hospital Crisis Watch tracks 1200+ facilities at risk. Protect Our Care
The broader context here is timing and payer mix, or who pays the bills for births. Obstetric units were already contracting on thin margins and low volume, like a small shop with high fixed costs and few shoppers. Closures tied to HR1 are occurring before full implementation, which suggests administrators are pricing in enrollment loss and reduced state allocations rather than waiting for realized revenue shortfalls. Rural units are most exposed.
Looking at what this means for access, the question is geographic concentration. If labor and delivery exits cluster where Medicaid finances a large share of births, patients face longer travel for delivery and prenatal triage while remaining hospitals absorb volume without a commensurate funding base. For policymakers and hospital operators, the next variables to watch are state responses to lower federal funding, the operational effect of work requirements and eligibility checks on coverage continuity, and whether at-risk rural facilities stabilize or follow the announced closures.
