H.R. 10728: Maternity Care for Rural Communities Act of 2026

This bill would change Medicaid payment rules so that certain federal limits on state-directed payments would not apply to some maternity, labor, and delivery services.

What would change

Under current law, states can direct Medicaid managed care plans to make certain payments to providers, but those payments are subject to federal limits. This bill would create an exception for payments tied to maternity, labor, and delivery care in certain settings, meaning those payments could exceed the usual cap.

Which services and hospitals are covered

The exception would apply to payments for maternity, labor, or delivery services for births occurring during rating periods beginning on or after July 4, 2025, if the payment is made to a specified entity. That term would include:

• Rural hospitals

• Hospitals operated by the Indian Health Service or by an Indian Tribe under federal law

• Hospitals where at least half of births in the most recent 12-month period were “qualifying births”

What counts as a qualifying birth

A birth would count as a qualifying birth if the person giving birth:

• Received maternity, labor, or delivery services paid for under Medicaid, CHIP, or Medicare

• Received those services through the Indian Health Service or a Native Hawaiian health care system

• Did not have minimum essential health coverage, and the hospital had uncompensated care costs related to the birth

Practical effect

In plain terms, the bill would let states use larger Medicaid-directed payments for childbirth-related care at certain hospitals, especially rural hospitals and hospitals serving a high share of publicly insured or uninsured patients. The bill appears aimed at supporting maternity care availability in communities where access may be limited.

Relevant Companies

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