US SB2059

Requires states to conduct studies every 5 years on the costs of providing maternity, labor, and delivery services at rural and safety net hospitals, with $10 million appropriated for grants to help small hospitals compile cost data

Mandates Medicaid payment rates for maternity services at eligible hospitals (rural, critical access, Indian Health Service, and those with 50%+ Medicaid/CHIP births) at minimum 150% of Medicare rates starting FY2027, with 100% federal matching for the enhanced payment portion

Creates annual "anchor payments" for low-volume obstetric hospitals (under 300 births/year) to ensure a revenue floor covering standby capacity costs ($1.2 million) plus per-delivery amounts ($10,000), with hospitals required to commit to continuing labor and delivery services for 2 years after receiving payments

Requires 12-month continuous, full-benefit Medicaid and CHIP coverage for pregnant individuals through the postpartum period, replacing the current optional state election, and mandates presumptive eligibility for pregnant women

Establishes notification requirements for hospitals closing obstetric units (180 days advance notice with community impact analysis) and requires hospitals to report detailed labor and delivery cost and revenue data in Medicare cost reports starting July 2026